Pub Date : 2025-12-08DOI: 10.1016/j.ctarc.2025.101066
Saeid Safiri , Kamaleddin Hassanzadeh , Ali Shamekh , Fateme Tahmasbi , Nima Naghdi-Sedeh , Asra Fazlollahi , Mark J.M. Sullman , Mortaza Raeisi , Zohreh Sanaat , Ali-Asghar Kolahi
Background
Bladder cancer (BC), as the most common malignancy of the urinary system, imposes a substantial epidemiological and economic burden worldwide. Due to its wide range of pathological properties, this disease requires various management methods, making it a challenging malignancy to control.
Methods
This study utilised data from the Global Burden of Disease 2021 study to detail the incidence, deaths and disability-adjusted life years (DALYs) attributable to bladder cancer, presented as counts and age-standardised rates with 95 % uncertainty intervals.
Results
In 2021, BC accounted for an age-standardised incidence of 8.2 per 100,000 (95 % UI: 6.9 to 10.0). This disease was also responsible for an age-standardised death rate of 3.2 (95 % UI: 2.8 % to 3.9 %) per 100,000. Furthermore, BC imposed an age-standardised DALY rate of 66.3 (95 % UI: 13.9 to 24.9) per 100,000 population. However, these three parameters have not changed significantly since 1990. Iraq, Kuwait, and Iran were the only countries that had large rises in their age-standardised incidence rates from 1990 to 2021, while Qatar and Bahrain showed significant declines in their age-standardised death and DALY rates.
Conclusions
The burden of bladder cancer increased in the region between 1990 and 2021, although this increase was not statistically significant. This observation may change as further evidence becomes available, particularly with larger sample sizes and longer periods of observation. Furthermore, these findings may also reflect advances in healthcare systems and diagnostic capabilities. As the population continues to grow and age, there is an increasing urgency for more effective preventive strategies to address the risk factors associated with bladder cancer.
{"title":"The burden of bladder cancer in the MENA region: a 3-decade analysis","authors":"Saeid Safiri , Kamaleddin Hassanzadeh , Ali Shamekh , Fateme Tahmasbi , Nima Naghdi-Sedeh , Asra Fazlollahi , Mark J.M. Sullman , Mortaza Raeisi , Zohreh Sanaat , Ali-Asghar Kolahi","doi":"10.1016/j.ctarc.2025.101066","DOIUrl":"10.1016/j.ctarc.2025.101066","url":null,"abstract":"<div><h3>Background</h3><div>Bladder cancer (BC), as the most common malignancy of the urinary system, imposes a substantial epidemiological and economic burden worldwide. Due to its wide range of pathological properties, this disease requires various management methods, making it a challenging malignancy to control.</div></div><div><h3>Methods</h3><div>This study utilised data from the Global Burden of Disease 2021 study to detail the incidence, deaths and disability-adjusted life years (DALYs) attributable to bladder cancer, presented as counts and age-standardised rates with 95 % uncertainty intervals.</div></div><div><h3>Results</h3><div>In 2021, BC accounted for an age-standardised incidence of 8.2 per 100,000 (95 % UI: 6.9 to 10.0). This disease was also responsible for an age-standardised death rate of 3.2 (95 % UI: 2.8 % to 3.9 %) per 100,000. Furthermore, BC imposed an age-standardised DALY rate of 66.3 (95 % UI: 13.9 to 24.9) per 100,000 population. However, these three parameters have not changed significantly since 1990. Iraq, Kuwait, and Iran were the only countries that had large rises in their age-standardised incidence rates from 1990 to 2021, while Qatar and Bahrain showed significant declines in their age-standardised death and DALY rates.</div></div><div><h3>Conclusions</h3><div>The burden of bladder cancer increased in the region between 1990 and 2021, although this increase was not statistically significant. This observation may change as further evidence becomes available, particularly with larger sample sizes and longer periods of observation. Furthermore, these findings may also reflect advances in healthcare systems and diagnostic capabilities. As the population continues to grow and age, there is an increasing urgency for more effective preventive strategies to address the risk factors associated with bladder cancer.</div></div>","PeriodicalId":9507,"journal":{"name":"Cancer treatment and research communications","volume":"46 ","pages":"Article 101066"},"PeriodicalIF":2.4,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145767239","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}
Background: Chronic obstructive pulmonary disease (COPD) is the most prevalent comorbidity among lung cancer patients, but its clinical and prognostic relationship with KRAS-mutant non-small cell lung cancer (NSCLC) remains unclear.
Methods: This multicenter retrospective cohort study enrolled 163 histologically confirmed KRAS-mutant NSCLC patients, including 59 with COPD and 104 without COPD. Clinical data consisted of baseline characteristics, co-mutation profiles, and survival outcomes were collected and efficacy evaluations. PFS and OS were compared using the Kaplan-Meier method and log-rank test.
Results: The COPD-LC group showed with a higher proportion of KRAS G12C mutations (47.4% vs. 26.2%, P = 0.028) and higher smoking rates (91.5% vs. 65.4%, P <0.001). Additionally, this group had a poorer baseline performance status and a higher Charlson Comorbidity Index. Chemoimmunotherapy significantly improved survival in advanced-stage NSCLC patients (mPFS: 9 vs. 6 months, HR = 0.62, P = 0.022; mOS: 24 vs. 11 months, HR = 0.53, P = 0.023), particularly those with COPD-comorbid lung cancer. Notably, within the COPD-LC subgroup, KRAS G12C-mutant patients achieved significantly longer median PFS compared to non-G12C subtypes (11.5 vs. 5 months, HR = 0.38, P = 0.009) and no significant differences in mPFS or mOS were observed between PS 0-1 and PS 2-3 groups. Co-mutations were identified in 78.6% of patients, with no significant intergroup differences.
Conclusion: COPD-comorbid KRAS-mutant NSCLC patients exhibit unique G12C subtype enrichment and distinct clinical features. Chemoimmunotherapy represents an effective first-line strategy for this population, particularly benefiting those with G12C mutations.
背景：慢性阻塞性肺疾病（COPD）是肺癌患者中最常见的合病，但其与kras突变的非小细胞肺癌（NSCLC）的临床和预后关系尚不清楚。方法：这项多中心回顾性队列研究纳入了163例组织学证实的kras突变型非小细胞肺癌患者，其中59例合并COPD， 104例未合并COPD。临床数据包括基线特征、共突变谱和生存结果的收集和疗效评估。采用Kaplan-Meier法和log-rank检验比较PFS和OS。结果：COPD-LC组KRAS G12C突变比例更高（47.4% vs. 26.2%, P = 0.028），吸烟率更高（91.5% vs. 65.4%）， P结论：copd合并KRAS突变的NSCLC患者表现出独特的G12C亚型富集和明显的临床特征。化疗免疫治疗是这一人群有效的一线治疗策略，尤其对G12C突变患者有益。
{"title":"Clinical characteristics and prognostic outcomes in KRAS-mutant non-small cell lung cancer: A real-world study with or without COPD comorbidity.","authors":"Chen Liao, Yubo Wang, Zhoukui Bi, Huawei Chen, Yu Xu, Defeng Hu, Rui Luo, Jiarui Wang, Zhi Xu, Yafei Li, Li Bai","doi":"10.1016/j.ctarc.2025.101064","DOIUrl":"https://doi.org/10.1016/j.ctarc.2025.101064","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) is the most prevalent comorbidity among lung cancer patients, but its clinical and prognostic relationship with KRAS-mutant non-small cell lung cancer (NSCLC) remains unclear.</p><p><strong>Methods: </strong>This multicenter retrospective cohort study enrolled 163 histologically confirmed KRAS-mutant NSCLC patients, including 59 with COPD and 104 without COPD. Clinical data consisted of baseline characteristics, co-mutation profiles, and survival outcomes were collected and efficacy evaluations. PFS and OS were compared using the Kaplan-Meier method and log-rank test.</p><p><strong>Results: </strong>The COPD-LC group showed with a higher proportion of KRAS G12C mutations (47.4% vs. 26.2%, P = 0.028) and higher smoking rates (91.5% vs. 65.4%, P <0.001). Additionally, this group had a poorer baseline performance status and a higher Charlson Comorbidity Index. Chemoimmunotherapy significantly improved survival in advanced-stage NSCLC patients (mPFS: 9 vs. 6 months, HR = 0.62, P = 0.022; mOS: 24 vs. 11 months, HR = 0.53, P = 0.023), particularly those with COPD-comorbid lung cancer. Notably, within the COPD-LC subgroup, KRAS G12C-mutant patients achieved significantly longer median PFS compared to non-G12C subtypes (11.5 vs. 5 months, HR = 0.38, P = 0.009) and no significant differences in mPFS or mOS were observed between PS 0-1 and PS 2-3 groups. Co-mutations were identified in 78.6% of patients, with no significant intergroup differences.</p><p><strong>Conclusion: </strong>COPD-comorbid KRAS-mutant NSCLC patients exhibit unique G12C subtype enrichment and distinct clinical features. Chemoimmunotherapy represents an effective first-line strategy for this population, particularly benefiting those with G12C mutations.</p>","PeriodicalId":9507,"journal":{"name":"Cancer treatment and research communications","volume":"46 ","pages":"101064"},"PeriodicalIF":2.4,"publicationDate":"2025-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146112586","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}
Pub Date : 2025-12-04DOI: 10.1016/j.ctarc.2025.101059
Song Wang , Jiahua He , Yuanbin Liao , Weihao Li , Weili Zhang , Da Kang , Weifeng Wang , Ruowei Wang , Chi Zhou , Junzhong Lin , Leen Liao , Jianhong Peng , Yuguang Lin
Background
: Colorectal liver oligometastasis (CLO) represents an intermediate state between localized and widely disseminated disease. Transforming growth factor-beta 1 (TGF-β1) plays a stage-dependent role in the tumorigenesis of colorectal cancer. However, its prognostic value and impact on the immune microenvironment in CLO remain poorly understood.
Methods
: We retrospectively analyzed 95 CLO patients who underwent curative resection of primary tumors and liver metastases. TGF-β1 expression was assessed by immunohistochemistry (IHC) in matched tumor and liver metastasis samples. Multiplex IHC and multispectral imaging were used to quantify CD3⁺, CD8⁺, and Foxp3⁺ T-cell infiltration in intratumoral and peritumoral compartments. Survival outcomes were compared using Kaplan–Meier analysis and Cox proportional hazards model. Associations with immune infiltration were subsequently validated through the analysis of TCGA colon adenocarcinoma datasets utilizing the TIMER2.0 platform.
Results
: The median IHC score for both primary tumors and liver metastases was 6. The consistency rate of TGF-β1 expression in primary tumors and liver metastases was 70 %. High TGF-β1 expression (≥6) in liver oligometastases was independently associated with poorer recurrence-free survival (RFS; HR = 3.689, 95 % CI: 1.799–7.567, P < 0.001) and overall survival (OS; HR = 3.131, 95 % CI: 1.278–7.669, P = 0.013). Patients with consistently high TGF-β1 expression in the primary tumors and liver metastases were associated with the poorest prognosis (P < 0.001). High TGF-β1 expression was associated with significantly reduced intratumoral CD3⁺ and CD8⁺ T cell infiltration and increased Foxp3⁺ regulatory T cell density (P < 0.05). This association was also observed in the cohort from TCGA.
Conclusion
: High TGF-β1 expression in CLO is associated with poor prognosis and an immunosuppressive microenvironment.
{"title":"Impact of TGF-β1 on tumor immune microenvironment and prognosis in colorectal liver oligometastasis","authors":"Song Wang , Jiahua He , Yuanbin Liao , Weihao Li , Weili Zhang , Da Kang , Weifeng Wang , Ruowei Wang , Chi Zhou , Junzhong Lin , Leen Liao , Jianhong Peng , Yuguang Lin","doi":"10.1016/j.ctarc.2025.101059","DOIUrl":"10.1016/j.ctarc.2025.101059","url":null,"abstract":"<div><h3>Background</h3><div><strong>:</strong> Colorectal liver oligometastasis (CLO) represents an intermediate state between localized and widely disseminated disease. Transforming growth factor-beta 1 (TGF-β1) plays a stage-dependent role in the tumorigenesis of colorectal cancer. However, its prognostic value and impact on the immune microenvironment in CLO remain poorly understood.</div></div><div><h3>Methods</h3><div><strong>:</strong> We retrospectively analyzed 95 CLO patients who underwent curative resection of primary tumors and liver metastases. TGF-β1 expression was assessed by immunohistochemistry (IHC) in matched tumor and liver metastasis samples. Multiplex IHC and multispectral imaging were used to quantify CD3⁺, CD8⁺, and Foxp3⁺ T-cell infiltration in intratumoral and peritumoral compartments. Survival outcomes were compared using Kaplan–Meier analysis and Cox proportional hazards model. Associations with immune infiltration were subsequently validated through the analysis of TCGA colon adenocarcinoma datasets utilizing the TIMER2.0 platform.</div></div><div><h3>Results</h3><div><strong>:</strong> The median IHC score for both primary tumors and liver metastases was 6. The consistency rate of TGF-β1 expression in primary tumors and liver metastases was 70 %. High TGF-β1 expression (≥6) in liver oligometastases was independently associated with poorer recurrence-free survival (RFS; HR = 3.689, 95 % CI: 1.799–7.567, <em>P</em> < 0.001) and overall survival (OS; HR = 3.131, 95 % CI: 1.278–7.669, <em>P</em> = 0.013). Patients with consistently high TGF-β1 expression in the primary tumors and liver metastases were associated with the poorest prognosis (<em>P</em> < 0.001). High TGF-β1 expression was associated with significantly reduced intratumoral CD3⁺ and CD8⁺ T cell infiltration and increased Foxp3⁺ regulatory T cell density (<em>P</em> < 0.05). This association was also observed in the cohort from TCGA.</div></div><div><h3>Conclusion</h3><div><strong>:</strong> High TGF-β1 expression in CLO is associated with poor prognosis and an immunosuppressive microenvironment.</div></div>","PeriodicalId":9507,"journal":{"name":"Cancer treatment and research communications","volume":"46 ","pages":"Article 101059"},"PeriodicalIF":2.4,"publicationDate":"2025-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145735074","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}
Pub Date : 2025-12-03DOI: 10.1016/j.ctarc.2025.101061
R.M.G. van Vuren , N. Wolfhagen , R.A.M. Damhuis , S. Kruijff , W.Y. van der Plas , W.H. Schreurs , O.C.J. Schuurbiers , H.J.M. Smit , A.F.T.M. Verhagen , M.W. Wouters , J. Belderbos , D.J. Heineman
Introduction
The COVID-19 pandemic significantly impacted lung cancer treatment, necessitating shifts in treatment modalities. Guidelines temporarily recommended SBRT as alternative to surgery for early-stage NSCLC.
Materials and Methods
This retrospective cohort study analyzed data from the Dutch Lung Cancer Audit – Radiotherapy (DLCA-R) and Surgery (DLCA-S) registries, including patients with Stage I NSCLC treated between 2018 and 2022. Patients were categorized into historic, pandemic, and post-pandemic cohorts. The primary endpoint was the percentage of surgical and radiotherapy treatments in these cohorts; secondary endpoints included time to treatment, complications, acute toxicity, and mortality.
Results
A total of 15,072 treatment episodes were analyzed. During the pandemic, the percentage of patients with Stage I NSCLC receiving radiotherapy increased significantly from 57 % to 65 %, while the percentage of patients undergoing surgery decreased. The shift towards radiotherapy persisted post-pandemic. Time to treatment and complication rates remained stable, though pulmonary embolism rates increased during the pandemic.
Conclusions
The pandemic led to a significant increase in radiotherapy for Stage I NSCLC, aligning with prevailing ESMO guidelines. However, this shift persisted post-pandemic when surgical capacity was restored. Short-term outcomes were unchanged.
{"title":"Impact of COVID-19 pandemic on treatment patterns for stage I Non-Small Cell Lung Cancer in the Netherlands","authors":"R.M.G. van Vuren , N. Wolfhagen , R.A.M. Damhuis , S. Kruijff , W.Y. van der Plas , W.H. Schreurs , O.C.J. Schuurbiers , H.J.M. Smit , A.F.T.M. Verhagen , M.W. Wouters , J. Belderbos , D.J. Heineman","doi":"10.1016/j.ctarc.2025.101061","DOIUrl":"10.1016/j.ctarc.2025.101061","url":null,"abstract":"<div><h3>Introduction</h3><div>The COVID-19 pandemic significantly impacted lung cancer treatment, necessitating shifts in treatment modalities. Guidelines temporarily recommended SBRT as alternative to surgery for early-stage NSCLC.</div></div><div><h3>Materials and Methods</h3><div>This retrospective cohort study analyzed data from the Dutch Lung Cancer Audit – Radiotherapy (DLCA-R) and Surgery (DLCA-S) registries, including patients with Stage I NSCLC treated between 2018 and 2022. Patients were categorized into historic, pandemic, and post-pandemic cohorts. The primary endpoint was the percentage of surgical and radiotherapy treatments in these cohorts; secondary endpoints included time to treatment, complications, acute toxicity, and mortality.</div></div><div><h3>Results</h3><div>A total of 15,072 treatment episodes were analyzed. During the pandemic, the percentage of patients with Stage I NSCLC receiving radiotherapy increased significantly from 57 % to 65 %, while the percentage of patients undergoing surgery decreased. The shift towards radiotherapy persisted post-pandemic. Time to treatment and complication rates remained stable, though pulmonary embolism rates increased during the pandemic.</div></div><div><h3>Conclusions</h3><div>The pandemic led to a significant increase in radiotherapy for Stage I NSCLC, aligning with prevailing ESMO guidelines. However, this shift persisted post-pandemic when surgical capacity was restored. Short-term outcomes were unchanged.</div></div>","PeriodicalId":9507,"journal":{"name":"Cancer treatment and research communications","volume":"46 ","pages":"Article 101061"},"PeriodicalIF":2.4,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145735115","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}
Gastrointestinal cancer represents a substantial global health challenge, contributing to over one-third of cancer-related mortality worldwide. The progression of these malignancies involves complex molecular and physiological mechanisms, with Midkine (MDK) emerging as a critical regulator. MDK, a heparin-binding growth factor, exhibits a multifaceted role in tumorigenesis, influencing cell proliferation, metastasis, angiogenesis, and chemoresistance. Elevated MDK expression has been identified in various gastrointestinal cancers, including gastric, esophageal, and colorectal malignancies, underscoring its potential as a diagnostic biomarker and therapeutic target. This review examines MDK’s molecular and biological functions in gastrointestinal cancers, emphasizing its clinical utility in diagnosis, prognosis, and therapy. By exploring the intricate mechanisms of MDK, this study aims to advance the development of novel, personalized therapeutic strategies to improve patient outcomes.
{"title":"The multifaceted role of midkine in gastrointestinal cancer: From biomarker to treatment","authors":"Zahra Rasoulizadeh , Amir Mohammad Nezhad Salari , Arezoo Gowhari Shabgah , Ghasem Sargazi , Roghayyeh Vakili-Ghartavol , Najmeh Mohammadpour , Reza Beheshti Monfared , Jamshid Gholizadeh","doi":"10.1016/j.ctarc.2025.101058","DOIUrl":"10.1016/j.ctarc.2025.101058","url":null,"abstract":"<div><div>Gastrointestinal cancer represents a substantial global health challenge, contributing to over one-third of cancer-related mortality worldwide. The progression of these malignancies involves complex molecular and physiological mechanisms, with Midkine (MDK) emerging as a critical regulator. MDK, a heparin-binding growth factor, exhibits a multifaceted role in tumorigenesis, influencing cell proliferation, metastasis, angiogenesis, and chemoresistance. Elevated MDK expression has been identified in various gastrointestinal cancers, including gastric, esophageal, and colorectal malignancies, underscoring its potential as a diagnostic biomarker and therapeutic target. This review examines MDK’s molecular and biological functions in gastrointestinal cancers, emphasizing its clinical utility in diagnosis, prognosis, and therapy. By exploring the intricate mechanisms of MDK, this study aims to advance the development of novel, personalized therapeutic strategies to improve patient outcomes.</div></div>","PeriodicalId":9507,"journal":{"name":"Cancer treatment and research communications","volume":"46 ","pages":"Article 101058"},"PeriodicalIF":2.4,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145735076","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}
Pub Date : 2025-12-02DOI: 10.1016/j.ctarc.2025.101056
Alexandra C. Preda , Rossitza Krasteva , Mihailo Stjepanović , Krassimir Koynov , Assia Konsoulova , Georgeta P. Iorga , Anghel A. Udrea , Anca Zgura , Tudor-Eliade Ciuleanu , Raluca Patru , Jeliazko Arabadjiev , Ivan Tonev , Zoran Andrić , Goran Stojanović , Mihaela Pasca-Fenesan , Edvina-Elena Pirvu , Bojidar Iliev , Ivan Kazmukov , Angel Petrov , Neda Nikolić , Michael Schenker
Background
Lung cancer is the leading cause of cancer deaths worldwide, with non-small cell lung cancer (NSCLC) being most common. This study examines how patient and tumor characteristics influences NSCLC treatment in Romania, Bulgaria, and Serbia, highlighting regional disparities and aiming to improve outcomes.
Methods
This retrospective cohort study of stage IV NSCLC patients in Romania, Bulgaria, and Serbia analyzed the impact of patient and tumor characteristics on treatment choices, timelines for diagnosis, biomarker testing, and imaging, using regression analyses.
Results
The study included 840 stage IV NSCLC patients (mean age 64.2 years) across Romania, Bulgaria, and Serbia, with 280 patients per country. Overall, chemo–immunotherapy (CIT) was most common (38.1 %), followed by immunotherapy (31.2 %). Bulgaria and Romania favored CIT, while Serbia’s options were limited by reimbursement. Factors influencing treatment included programmed death-ligand 1 (PD-L1) status and gene mutation profile in Bulgaria, weight loss and appetite in Romania, and smoking status and symptoms in Serbia. Testing and treatment initiation times varied, with Serbia showing the shortest times. PD-L1 status and Eastern Cooperative Oncology Group performance were crucial across all countries. Common symptoms included chest pain, cough, shortness of breath, and general pain, with varying frequencies across countries.
Conclusion
This retrospective three-country real-world cohort shows marked regional differences in first-line treatment and timing for stage IV NSCLC. Beyond clinical factors, health-system elements, reimbursement, biomarker-testing availability/turnaround, and access to chemo-immunotherapy, shape care. Addressing these offers policy-level opportunities to improve equitable, guideline-concordant treatment. Initiated after the most heated phase of the COVID-19 pandemic and conducted without contingency measures, thus study highlights the need for personalized medicine and improved healthcare infrastructure to address disparities in treatment and testing times.
MicroAbstract
Non-small cell lung cancer (NSCLC) is the most common type of lung cancer worldwide. In this retrospective cohort study we examined how patient and tumor characteristics influences NSCLC treatment in Romania, Bulgaria, and Serbia, and revealed significant regional differences in baseline characteristics, treatment preferences, and influencing factors for stage IV NSCLC in these countries.
{"title":"Impact of patient and tumor characteristics on various aspects of the non-small cell lung cancer patient journey in Romania, Bulgaria, Serbia: A multicenter, non-interventional, retrospective cohort study","authors":"Alexandra C. Preda , Rossitza Krasteva , Mihailo Stjepanović , Krassimir Koynov , Assia Konsoulova , Georgeta P. Iorga , Anghel A. Udrea , Anca Zgura , Tudor-Eliade Ciuleanu , Raluca Patru , Jeliazko Arabadjiev , Ivan Tonev , Zoran Andrić , Goran Stojanović , Mihaela Pasca-Fenesan , Edvina-Elena Pirvu , Bojidar Iliev , Ivan Kazmukov , Angel Petrov , Neda Nikolić , Michael Schenker","doi":"10.1016/j.ctarc.2025.101056","DOIUrl":"10.1016/j.ctarc.2025.101056","url":null,"abstract":"<div><h3>Background</h3><div>Lung cancer is the leading cause of cancer deaths worldwide, with non-small cell lung cancer (NSCLC) being most common. This study examines how patient and tumor characteristics influences NSCLC treatment in Romania, Bulgaria, and Serbia, highlighting regional disparities and aiming to improve outcomes.</div></div><div><h3>Methods</h3><div>This retrospective cohort study of stage IV NSCLC patients in Romania, Bulgaria, and Serbia analyzed the impact of patient and tumor characteristics on treatment choices, timelines for diagnosis, biomarker testing, and imaging, using regression analyses.</div></div><div><h3>Results</h3><div>The study included 840 stage IV NSCLC patients (mean age 64.2 years) across Romania, Bulgaria, and Serbia, with 280 patients per country. Overall, chemo–immunotherapy (CIT) was most common (38.1 %), followed by immunotherapy (31.2 %). Bulgaria and Romania favored CIT, while Serbia’s options were limited by reimbursement. Factors influencing treatment included programmed death-ligand 1 (PD-L1) status and gene mutation profile in Bulgaria, weight loss and appetite in Romania, and smoking status and symptoms in Serbia. Testing and treatment initiation times varied, with Serbia showing the shortest times. PD-L1 status and Eastern Cooperative Oncology Group performance were crucial across all countries. Common symptoms included chest pain, cough, shortness of breath, and general pain, with varying frequencies across countries.</div></div><div><h3>Conclusion</h3><div>This retrospective three-country real-world cohort shows marked regional differences in first-line treatment and timing for stage IV NSCLC. Beyond clinical factors, health-system elements, reimbursement, biomarker-testing availability/turnaround, and access to chemo-immunotherapy, shape care. Addressing these offers policy-level opportunities to improve equitable, guideline-concordant treatment. Initiated after the most heated phase of the COVID-19 pandemic and conducted without contingency measures, thus study highlights the need for personalized medicine and improved healthcare infrastructure to address disparities in treatment and testing times.</div></div><div><h3>MicroAbstract</h3><div>Non-small cell lung cancer (NSCLC) is the most common type of lung cancer worldwide. In this retrospective cohort study we examined how patient and tumor characteristics influences NSCLC treatment in Romania, Bulgaria, and Serbia, and revealed significant regional differences in baseline characteristics, treatment preferences, and influencing factors for stage IV NSCLC in these countries.</div></div>","PeriodicalId":9507,"journal":{"name":"Cancer treatment and research communications","volume":"46 ","pages":"Article 101056"},"PeriodicalIF":2.4,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145735075","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}
Pub Date : 2025-12-02DOI: 10.1016/j.ctarc.2025.101054
Pasquale Rescigno , Alastair Greystoke
Next-generation sequencing (NGS) offers broad molecular profiling that reveals genetic variation, gene expression and epigenetic modifications. This information is essential for identifying actionable biomarkers, enabling informed clinical decision-making and allowing therapeutic targeting of specific genetic alterations. International guidelines recommend biomarker testing in suitable patients, as targeted therapy offers greater benefits than non-specific chemotherapy. Several factors are pivotal for maximising the clinical utility and integration biomarker testing approaches in clinical practice. While utilising genomic information from NGS is becoming part of routine oncology practice, the integration of the significant complexity of the sequencing data can be challenging. Therefore, the involvement of multidisciplinary teams in precision oncology including oncologists, pathologists, radiologists, molecular biologists/geneticists and bioinformaticians is the need of the hour. Here, we highlight the complexities of NGS techniques and reporting that guide clinical decision-making in oncology, and also provide UK expert perspectives on the integration of NGS into local treatment practices.
{"title":"Illuminating the spectrum of genomic sequencing approaches in the precision oncology era: A UK perspective","authors":"Pasquale Rescigno , Alastair Greystoke","doi":"10.1016/j.ctarc.2025.101054","DOIUrl":"10.1016/j.ctarc.2025.101054","url":null,"abstract":"<div><div>Next-generation sequencing (NGS) offers broad molecular profiling that reveals genetic variation, gene expression and epigenetic modifications. This information is essential for identifying actionable biomarkers, enabling informed clinical decision-making and allowing therapeutic targeting of specific genetic alterations. International guidelines recommend biomarker testing in suitable patients, as targeted therapy offers greater benefits than non-specific chemotherapy. Several factors are pivotal for maximising the clinical utility and integration biomarker testing approaches in clinical practice. While utilising genomic information from NGS is becoming part of routine oncology practice, the integration of the significant complexity of the sequencing data can be challenging. Therefore, the involvement of multidisciplinary teams in precision oncology including oncologists, pathologists, radiologists, molecular biologists/geneticists and bioinformaticians is the need of the hour. Here, we highlight the complexities of NGS techniques and reporting that guide clinical decision-making in oncology, and also provide UK expert perspectives on the integration of NGS into local treatment practices.</div></div>","PeriodicalId":9507,"journal":{"name":"Cancer treatment and research communications","volume":"46 ","pages":"Article 101054"},"PeriodicalIF":2.4,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145735114","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}
Pub Date : 2025-12-02DOI: 10.1016/j.ctarc.2025.101055
Xinglong Li, Guangsong Tang, Wenyue Wang, Chen Zhang, Yu Xue, Ning Xu, Qing fa Wu, Wei qiang Yu
Background
Lung cancer is a highly prevalent and invasive malignancy, characterized by profound metabolic reprogramming as one of its key features. The advent of single-cell RNA sequencing (scRNA-seq) has allowed us to study cellular metabolism in greater detail. In this study, we systematically explore the metabolic pathways of distinct cell types within the lung cancer tumor microenvironment using scRNA-seq data. Moreover, we identify potential biomarkers with diagnostic and prognostic significance.
Methods
We leveraged scRNA-seq data from lung cancer to map the metabolic landscape of different cell types in the tumor microenvironment. Malignant cells were classified into three distinct subgroups based on their metabolic activity: high-metabolism, intermediate-metabolism, and low-metabolism.
Results
Malignant cells exhibit significantly higher metabolic activity compared to non-malignant cell types. The low-metabolism state was strongly associated with immune signaling pathways, with FSCN1 identified as a key marker. This state revealed a distinct population of cells enriched for cancer stem cell (CSC)-like characteristics.
Conclusion
This study provides a comprehensive exploration of the metabolic characteristics of malignant cells in lung cancer at single-cell resolution. Our findings provide insights that could improve prognosis and support more targeted treatments for lung cancer patients.
{"title":"Single-cell analysis of lung cancer metabolism and its clinical implications","authors":"Xinglong Li, Guangsong Tang, Wenyue Wang, Chen Zhang, Yu Xue, Ning Xu, Qing fa Wu, Wei qiang Yu","doi":"10.1016/j.ctarc.2025.101055","DOIUrl":"10.1016/j.ctarc.2025.101055","url":null,"abstract":"<div><h3>Background</h3><div>Lung cancer is a highly prevalent and invasive malignancy, characterized by profound metabolic reprogramming as one of its key features. The advent of single-cell RNA sequencing (scRNA-seq) has allowed us to study cellular metabolism in greater detail. In this study, we systematically explore the metabolic pathways of distinct cell types within the lung cancer tumor microenvironment using scRNA-seq data. Moreover, we identify potential biomarkers with diagnostic and prognostic significance.</div></div><div><h3>Methods</h3><div>We leveraged scRNA-seq data from lung cancer to map the metabolic landscape of different cell types in the tumor microenvironment. Malignant cells were classified into three distinct subgroups based on their metabolic activity: high-metabolism, intermediate-metabolism, and low-metabolism.</div></div><div><h3>Results</h3><div>Malignant cells exhibit significantly higher metabolic activity compared to non-malignant cell types. The low-metabolism state was strongly associated with immune signaling pathways, with <em>FSCN1</em> identified as a key marker. This state revealed a distinct population of cells enriched for cancer stem cell (CSC)-like characteristics.</div></div><div><h3>Conclusion</h3><div>This study provides a comprehensive exploration of the metabolic characteristics of malignant cells in lung cancer at single-cell resolution. Our findings provide insights that could improve prognosis and support more targeted treatments for lung cancer patients.</div></div>","PeriodicalId":9507,"journal":{"name":"Cancer treatment and research communications","volume":"46 ","pages":"Article 101055"},"PeriodicalIF":2.4,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145683926","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}
Pub Date : 2025-12-02DOI: 10.1016/j.ctarc.2025.101057
Huange Zhu, Burong Li, Jie Lu, Zeqi Guo
Lung cancer is one of the most common types of cancer and the leading cause of cancer-related deaths worldwide, including China. Early-stage treatment involves anatomical lung resection, while advanced stages require chemotherapy or radiotherapy. Computed tomography screening has been widely used for lung cancer screening, but over 24 % of CT-screened individuals have pulmonary abnormalities that require further investigation. The healthcare system is burdened by these indeterminate abnormalities, with large numbers of nodules being false positives. Biomarkers have been used to identify cancer patients or monitor treatment response. Research on molecular biomarkers for lung cancer includes autoantibodies, blood protein profiling, complement fragments, microRNAs, DNA methylation, and circulating tumor DNA. Blood-based biomarkers offer benefits such as easy acquisition, low cost, minimal patient invasiveness, and established procedures for specimen preparation and assay performance. Panels of biomarkers have been researched for higher sensitivity or specificity, allowing clinicians to rule out malignancy in IPNs found during LDCT screening. For individuals who can benefit from therapy for an extended period, continuous monitoring of changes in indicators during treatment is more sensible. Developing a cost-effective, efficient, and convenient strategy for early lung cancer diagnosis could significantly impact patient management. Further research is needed to determine if biomarkers found from patients with established disease can be used on samples taken earlier in the diagnostic process or at a preclinical stage.
{"title":"Profiles of blood biomarkers in lung cancer","authors":"Huange Zhu, Burong Li, Jie Lu, Zeqi Guo","doi":"10.1016/j.ctarc.2025.101057","DOIUrl":"10.1016/j.ctarc.2025.101057","url":null,"abstract":"<div><div>Lung cancer is one of the most common types of cancer and the leading cause of cancer-related deaths worldwide, including China. Early-stage treatment involves anatomical lung resection, while advanced stages require chemotherapy or radiotherapy. Computed tomography screening has been widely used for lung cancer screening, but over 24 % of CT-screened individuals have pulmonary abnormalities that require further investigation. The healthcare system is burdened by these indeterminate abnormalities, with large numbers of nodules being false positives. Biomarkers have been used to identify cancer patients or monitor treatment response. Research on molecular biomarkers for lung cancer includes autoantibodies, blood protein profiling, complement fragments, microRNAs, DNA methylation, and circulating tumor DNA. Blood-based biomarkers offer benefits such as easy acquisition, low cost, minimal patient invasiveness, and established procedures for specimen preparation and assay performance. Panels of biomarkers have been researched for higher sensitivity or specificity, allowing clinicians to rule out malignancy in IPNs found during LDCT screening. For individuals who can benefit from therapy for an extended period, continuous monitoring of changes in indicators during treatment is more sensible. Developing a cost-effective, efficient, and convenient strategy for early lung cancer diagnosis could significantly impact patient management. Further research is needed to determine if biomarkers found from patients with established disease can be used on samples taken earlier in the diagnostic process or at a preclinical stage.</div></div>","PeriodicalId":9507,"journal":{"name":"Cancer treatment and research communications","volume":"46 ","pages":"Article 101057"},"PeriodicalIF":2.4,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145683927","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}
: Androgen receptor (AR) signaling is known to contribute to the progression of various cancers, including oral squamous cell carcinoma (OSCC). However, its role in oral lichen planus (OLP), a chronic inflammatory disorder with malignant potential, remains poorly understood. This preliminary study aimed to evaluate AR expression in OLP and OSCC tissues and explore its potential involvement in their pathogenesis.
Methods
: A cross-sectional study was conducted using 50 paraffin-embedded tissue samples (25 OLP and 25 OSCC). AR expression was assessed by immunohistochemistry and graded based on the percentage of positively stained cells. Statistical analysis was performed to compare AR expression between groups.
Results
: AR expression was observed in 28% of OLP and 40% of OSCC samples. No significant difference in AR expression was found between OLP and OSCC tissues. In OSCC, AR expression did not significantly vary across tumor grades. Notably, age-matched analysis showed similar AR expression patterns in both groups.
Conclusion
: These preliminary findings suggest that AR signaling may contribute to shared molecular pathways linking chronic inflammation with carcinogenesis. Further large-scale studies are required to confirm these observations.
{"title":"Preliminary study of androgen receptor expression in oral lichen planus and oral squamous cell carcinoma: A comparative cross-sectional analysis","authors":"Shiva Shirazian , Saeide Tehranchi , Nazanin Mahdavi , Mohammad Javad Kharazifard , Mahdieh-Sadat Moosavi","doi":"10.1016/j.ctarc.2025.101050","DOIUrl":"10.1016/j.ctarc.2025.101050","url":null,"abstract":"<div><h3>Purpose</h3><div><strong>:</strong> Androgen receptor (AR) signaling is known to contribute to the progression of various cancers, including oral squamous cell carcinoma (OSCC). However, its role in oral lichen planus (OLP), a chronic inflammatory disorder with malignant potential, remains poorly understood. This preliminary study aimed to evaluate AR expression in OLP and OSCC tissues and explore its potential involvement in their pathogenesis.</div></div><div><h3>Methods</h3><div><strong>:</strong> A cross-sectional study was conducted using 50 paraffin-embedded tissue samples (25 OLP and 25 OSCC). AR expression was assessed by immunohistochemistry and graded based on the percentage of positively stained cells. Statistical analysis was performed to compare AR expression between groups.</div></div><div><h3>Results</h3><div><strong>:</strong> AR expression was observed in 28% of OLP and 40% of OSCC samples. No significant difference in AR expression was found between OLP and OSCC tissues. In OSCC, AR expression did not significantly vary across tumor grades. Notably, age-matched analysis showed similar AR expression patterns in both groups.</div></div><div><h3>Conclusion</h3><div><strong>:</strong> These preliminary findings suggest that AR signaling may contribute to shared molecular pathways linking chronic inflammation with carcinogenesis. Further large-scale studies are required to confirm these observations.</div></div>","PeriodicalId":9507,"journal":{"name":"Cancer treatment and research communications","volume":"46 ","pages":"Article 101050"},"PeriodicalIF":2.4,"publicationDate":"2025-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145721028","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}
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