Cancer treatment and research communications最新文献_第7页

Bioinformatic-based study to investigate the fluctuations and performance of MYD88 and GRB2 gene expression in gastric cancer; Can they be considered diagnostic biomarkers? 基于生物信息学的研究MYD88和GRB2基因在胃癌中的表达波动及表现；它们可以被视为诊断性生物标志物吗？

IF 2.4 Q3 Medicine

Cancer treatment and research communications

Pub Date : 2025-01-01 DOI: 10.1016/j.ctarc.2025.101006

Seyed Mustafa Mirnezami , Saman Morovat , Afshin Shafaghi , Seyedeh Elham Norollahi , Kourosh Delpasand , Kosar Babaei , Ali Ashraf , Ali Akbar Samadani

Gastric cancer (GC) ranks as the fourth most prevalent malignancy and constitutes the second leading cause of cancer-related mortality globally. The elevated mortality rate is linked to molecular heterogeneity, late-stage diagnosis, and the limited efficacy of existing therapies. Recent developments in bioinformatics have facilitated the discovery of new biomarkers and therapeutic targets, essential for enhancing diagnosis, prognosis, and treatment approaches in gastric cancer. This study examines the bioinformatics analysis of two significant genes, GRB2 (Growth factor receptor-bound protein 2) and MYD88 (Myeloid differentiation primary response 88), associated with gastric cancer progression and immune response regulation.

We analyzed data from public databases such as GEPIA2, TIMER, GeneMANIA, and Cytoscape to examine the differential expression of GRB2 and MYD88 in gastric cancer tissues versus normal tissues, their roles in protein-protein interaction networks, and their association with immune infiltration. The findings indicate that elevated GRB2 expression correlates significantly with tumor invasion, underscoring its potential as an independent prognostic marker and therapeutic target in gastric cancer. The expression of MYD88 is associated with the activation of the NF-κB signaling pathway, which is induced by Helicobacter pylori infection, thereby contributing to chronic inflammation and tumorigenesis.

Functional enrichment analysis, encompassing KEGG and GO, indicated that both genes are involved in essential oncogenic pathways, such as cell proliferation, immune response regulation, and inflammatory signaling. The results indicate that GRB2 and MYD88 may function as significant biomarkers for patient stratification and should be considered in the formulation of targeted therapies for gastric cancer.

This study highlights the importance of GRB2 and MYD88 in the progression of gastric cancer and proposes their potential as therapeutic targets to enhance patient outcomes.

胃癌（GC）是全球第四大最常见的恶性肿瘤，也是全球癌症相关死亡的第二大原因。死亡率升高与分子异质性、晚期诊断和现有治疗方法的有限疗效有关。生物信息学的最新发展促进了新的生物标志物和治疗靶点的发现，这对提高胃癌的诊断、预后和治疗方法至关重要。本研究对与胃癌进展和免疫反应调控相关的两个重要基因GRB2（生长因子受体结合蛋白2）和MYD88（髓样分化初级反应88）进行了生物信息学分析。我们分析了来自GEPIA2、TIMER、GeneMANIA和Cytoscape等公共数据库的数据，以检测胃癌组织与正常组织中GRB2和MYD88的差异表达、它们在蛋白-蛋白相互作用网络中的作用以及它们与免疫浸润的关联。研究结果表明，GRB2表达升高与肿瘤侵袭显著相关，强调了其作为胃癌独立预后标志物和治疗靶点的潜力。MYD88的表达与幽门螺杆菌感染诱导的NF-κB信号通路的激活有关，从而参与慢性炎症和肿瘤的发生。包括KEGG和GO的功能富集分析表明，这两个基因都参与了必要的致癌途径，如细胞增殖、免疫反应调节和炎症信号传导。结果表明，GRB2和MYD88可能作为患者分层的重要生物标志物，在制定胃癌靶向治疗方案时应予以考虑。本研究强调了GRB2和MYD88在胃癌进展中的重要性，并提出了它们作为提高患者预后的治疗靶点的潜力。

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引用次数: 0

Long-term oncologic outcome of intraoperative radiotherapy (IORT) with low-energy X-rays as a tumor-bed boost in Korean patients with breast cancer 韩国乳腺癌患者术中使用低能量 X 射线作为肿瘤床增量的放射治疗 (IORT) 的长期肿瘤学疗效

Q3 Medicine

Cancer treatment and research communications

Pub Date : 2025-01-01 DOI: 10.1016/j.ctarc.2025.100925

Seung Ho Baek , Soong June Bae , Yoonwon Kook , Yeona Cho , Sung Gwe Ahn , Jun Won Kim , Ik Jae Lee , Joon Jeong

Background

Although the use of intraoperative radiotherapy (IORT) for accelerated partial breast irradiation is growing, there are not many studies on its effectiveness specifically in Asian population. In this study, we aimed to investigate the long-term oncologic outcomes of Korean patients who received IORT with low-energy X-ray as a tumor-bed boost.

Methods

We conducted phase II, prospective, single-arm trial to evaluate the local toxicity and oncologic outcomes in breast cancer patients receiving IORT with low-energy X-rays as a tumor-bed boost (NCT02213991). Patients underwent IORT as a tumor-bed boost with low-energy X-rays (20 Gy) followed by external beam radiotherapy for whole breast irradiation (46 Gy). Patients diagnosed with early-stage breast cancer or ductal carcinoma in situ who were suitable for lumpectomy were considered eligible. Kaplan-Meier analysis was used to assess oncologic outcomes with an extended follow-up period.

Results

A total of 194 patients underwent IORT between August 2014 and September 2016 according to the protocol outlined in our study. During the median follow-up of 85.6 months, 12 cases (6.19 %) of recurrence were reported, of which 4 (2.06 %) were reported ipsilateral breast tumor recurrence (IBTR) as the first recurrence event. The 5- and 8-year IBTR rates were both 2.1 % (95 % confidence intervals (CIs), 93.8 – 98.9). The 5-year loco-regional recurrence-free survival (LRRFS), recurrence-free survival (RFS), and overall survival (OS) rates were 97.37 %, 96.32 %, and 100 %, respectively.

Conclusion

We identified the oncologic safety of IORT with low-energy X-rays as a tumor-bed boost in Korean patients during an extended follow-up period.

虽然术中放疗（IORT）用于加速乳房部分照射的使用正在增加，但关于其在亚洲人群中的有效性的研究并不多。在这项研究中，我们的目的是调查韩国患者接受低能量x线作为肿瘤床促进IORT的长期肿瘤预后。方法我们进行了一项II期、前瞻性、单臂试验，以评估接受IORT的乳腺癌患者的局部毒性和肿瘤预后，低能x射线作为肿瘤床增强（NCT02213991）。患者接受IORT作为肿瘤床的低能x射线（20 Gy）增强，然后进行全乳外束放疗（46 Gy）。诊断为早期乳腺癌或原位导管癌的患者适合进行乳房肿瘤切除术。Kaplan-Meier分析用于评估延长随访期的肿瘤预后。结果2014年8月至2016年9月期间，共有194例患者接受了IORT治疗。中位随访85.6个月，报告复发12例（6.19%），其中以同侧乳腺肿瘤复发（IBTR）为首发复发事件4例（2.06%）。5年和8年IBTR率均为2.1%（95%置信区间（ci）， 93.8 - 98.9）。5年局部-区域无复发生存率（LRRFS）、无复发生存率（RFS）和总生存率（OS）分别为97.37%、96.32%和100%。结论：在延长的随访期间，我们通过低能x射线确定了IORT的肿瘤学安全性，作为肿瘤床的提高。

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引用次数: 0

Durvalumab consolidation after chemoradiotherapy in unresectable stage III non–small cell lung cancer: A real-world experience from the Australian subset of PACIFIC-R 不可切除的III期非小细胞肺癌放化疗后Durvalumab巩固：来自澳大利亚PACIFIC-R亚群的真实世界经验

Q3 Medicine

Cancer treatment and research communications

Pub Date : 2025-01-01 DOI: 10.1016/j.ctarc.2025.100929

Ben Markman , Steven Kao , Nick Pavlakis , Victoria Bray , Leisl Packer , Shankar Siva

MicroAbstract

Australian subset of the multicentric PACIFIC-R study (NCT03798535) in patients with unresectable, stage III non-small cell lung cancer without progression following chemoradiotherapy, found a median progression-free survival of 22.4 months (95% confidence interval, 17.5 to 30.8) confirming clinical benefit of durvalumab consolidation post-chemoradiotherapy in the real-world setting.

Introduction

The Phase 3 PACIFIC trial established post-chemoradiotherapy (CRT) durvalumab consolidation as standard treatment for patients with unresectable, stage III non-small cell lung cancer (NSCLC). We present the results from the Australian subset of the multicentric PACIFIC-R study (NCT03798535) assessing the effectiveness of durvalumab in the real-world setting.

Patients and Methods

Patients with unresectable, stage III NSCLC without progression following CRT, receiving at least 1 dose of durvalumab (10 mg/kg intravenously, every 2 weeks) through an early access program (EAP) between September 2017 and December 2019, were enrolled. Primary endpoints, progression-free survival (PFS) and overall survival (OS) were analyzed by Kaplan–Meier method.

Results: As of February 7, 2022, 165 patients (median age

67.0 years) with a median follow-up of 34.7 months were enrolled. Most received last radiation ≥42 days before durvalumab initiation (126, 79.2%) at a dose of 54 to 60 Gy (141, 88.7%). Median PFS was 22.4 months (95% confidence interval [CI], 17.5 to 30.8). The 3-year PFS and OS rates were 38.9% (95% CI, 31.0 to 46.7) and 59.1% (95% CI, 51.2 to 66.2). Pneumonitis was the most frequent adverse events of special interest (27, 16.4%); which led to treatment discontinuation in 19 (11.5%) patients.

Conclusion

The real-world results from the Australian PACIFIC-R subset confirm translation of the clinical benefit of post-CRT durvalumab consolidation in the pivotal PACIFIC trial to the real-world setting, showing favorable survival outcomes, irrespective of delays in durvalumab initiation post-radiation.

多中心PACIFIC-R研究（NCT03798535）的澳大利亚亚组在放化疗后无进展的不可切除III期非小细胞肺癌患者中发现，中位无进展生存期为22.4个月（95%置信区间，17.5至30.8），证实了在现实环境中，durvalumab在放化疗后巩固的临床益处。3期PACIFIC试验将化疗后（CRT） durvalumab巩固作为不可切除的III期非小细胞肺癌（NSCLC）患者的标准治疗。我们报告了多中心PACIFIC-R研究（NCT03798535）澳大利亚亚组的结果，该研究评估了durvalumab在现实环境中的有效性。患者和方法纳入了2017年9月至2019年12月期间通过早期准入计划（EAP）接受至少1剂量durvalumab （10mg /kg静脉注射，每2周）的不可切除III期NSCLC患者，CRT后无进展。主要终点、无进展生存期（PFS）和总生存期（OS）采用Kaplan-Meier法分析。结果：截至2022年2月7日，纳入165例患者（中位年龄67.0岁），中位随访时间为34.7个月。大多数患者在durvalumab起始治疗前≥42天接受最后一次放疗（126,79.2%），剂量为54 - 60 Gy（141,488.7%）。中位PFS为22.4个月（95%可信区间[CI]， 17.5至30.8）。3年PFS和OS分别为38.9% （95% CI, 31.0 ~ 46.7）和59.1% （95% CI, 51.2 ~ 66.2）。肺炎是最常见的特殊不良事件（27例，16.4%）；这导致19例（11.5%）患者停止治疗。来自澳大利亚PACIFIC- r亚组的真实结果证实了关键PACIFIC试验中crt后durvalumab巩固的临床获益转化为真实环境，显示出有利的生存结果，无论durvalumab放射后启动延迟如何。

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引用次数: 0

Carfilzomib in relapsed/refractory multiple myeloma patients – real world evidence – experiences of the Croatian cooperative group for hematologic diseases (KROHEM) 卡非佐米在复发/难治性多发性骨髓瘤患者中的应用——真实世界的证据——克罗地亚血液病合作小组（KROHEM）的经验

Q3 Medicine

Cancer treatment and research communications

Pub Date : 2025-01-01 DOI: 10.1016/j.ctarc.2025.100912

Davor Galusic , Josip Batinic , Ivan Krecak , Barbara Dreta , Delfa Radic Kristo , Mario Pirsic , Goran Rincic , Jasminka Sincic-Petricevic , Toni Valkovic , Milan Vujcic , Marin Simunic , Karla Misura Jakobac , Martina Sedinic Lacko , Klara Brcic , Vlatka Perisa , Fran Petricevic , Dragana Grohovac , Hrvoje Holik , Martina Moric Peric , Ivan Zekanovic , Sandra Basic-Kinda

Background

Carfilzomib-based regimens brought a significant improvement in the treatment of relapsed/refractory multiple myeloma (RRMM). Even though efficacy and safety profiles of carfilzomib are well-established in several clinical trials, there is limited real-world data with carfilzomib-based protocols. Here we present our real-world experience with carfilzomib-based regimens for treatment of patients with RRMM in Croatia.

Methods

Data on patients with RRMM starting carfilzomib-based protocols in the period between June 2019 and February 2023 was collected by retrospective chart review from 14 Croatian centres.

Results

A total of 119 patients with RRMM were included; median age was 66 years (range 45–83 years), 59 (49.6 %) were females, and the median number of previous lines of therapies was 2 (range 1–8). Triplet based regimen was treatment choice in 84 (70.6 %) and 35 (29.4 %) patients were treated with carfilzomib in combination with dexamethasone (Kd). Overall response rate was 61.7 %, with 20 patients (18.7 %) achieving complete response (CR). Median progression free survival (PFS) and overall survival (OS) for entire cohort were 9.4 and 13.2 months, respectively. Median PFS was 12.8 months and 4.1 months for the triplets and doublets, respectively; the corresponding median OS was 18.6 and 7.9 months, respectively. The most common adverse events were anemia and thrombocytopenia; 19 patients (16 %) experienced cardiovascular events.

Conclusion

This is the first study to analyze clinical outcomes of RRMM patients treated with carfilzomib-based regimens in Croatia. Carfilzomib-based regimens showed substantial efficacy and acceptable toxicity in RRMM, especially in earlier treatment lines and triplet combinations.

背景以卡非佐米为基础的治疗方案大大改善了复发性/难治性多发性骨髓瘤（RRMM）的治疗。尽管卡非佐米的疗效和安全性已在多项临床试验中得到证实，但基于卡非佐米方案的真实世界数据却十分有限。在此，我们介绍克罗地亚RRMM患者使用卡非佐米方案治疗的实际经验。方法通过回顾性病历审查收集了2019年6月至2023年2月期间开始使用卡非佐米方案的RRMM患者数据，数据来自14个克罗地亚中心。结果共纳入119例RRMM患者；中位年龄为66岁（范围为45-83岁），59例（49.6%）为女性，既往治疗次数的中位数为2次（范围为1-8次）。84名患者（70.6%）选择了三联疗法，35名患者（29.4%）选择了卡非佐米联合地塞米松（Kd）疗法。总反应率为61.7%，其中20名患者（18.7%）获得完全反应（CR）。整个队列的中位无进展生存期（PFS）和总生存期（OS）分别为9.4个月和13.2个月。三联疗法和双联疗法的中位无进展生存期分别为12.8个月和4.1个月；相应的中位总生存期分别为18.6个月和7.9个月。最常见的不良反应是贫血和血小板减少；19 名患者（16%）发生了心血管事件。以卡非佐米为基础的治疗方案对RRMM显示出显著疗效和可接受的毒性，尤其是在早期治疗线和三联疗法中。

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引用次数: 0

Analysis of operability parameter changes in neoadjuvant treatment with chemotherapy and anti-PD-1/PD-L1 化疗联合抗pd -1/PD-L1新辅助治疗可操作性参数变化分析

Q3 Medicine

Cancer treatment and research communications

Pub Date : 2025-01-01 DOI: 10.1016/j.ctarc.2025.100910

M Sereno , A Collazo-Lorduy , Y Garitaonaindia , D Gómez de Antonio , J Baena Espinar , C Aguado de la Rosa , P Cruz Castellanos , S Falagán Martínez , LE Chara Valverde , R López-Castro , A López-Martin , J Rubio-Pérez , A Gómez Rueda , C Traseira Puchol , X Mielgo Rubio , B Losada Vila , J Rogado , E Bernal Hertfelder , L Gutiérrez Sainz , JL Campo-Cañaveral , E Casado Sáenz

Background

The adoption of combined chemotherapy (CT) and immunotherapy (IO) has advanced neoadjuvant therapy (NA) for non-small cell lung cancer (NSCLC), but data on functional impacts are limited. This multicenter retrospective study evaluates respiratory function in NSCLC patients undergoing NA.

Methods

From 2020 to 2024, 186 patients treated with CT or CT-IO (anti-PD-1/PD-L1) were analyzed. Respiratory tests (DLCO, FEV1, FVC) pre- and post-NA were compared, alongside clinical, pathological, and surgical variables.

Results

Median age: 68; 66.6 % male; 93 % smokers/ex-smokers, histologies: Squamous and adenocarcinoma (46 % each), DLCO decline was greater in CT-IO vs. CT (-12.6 % vs. -7.8 %, p = 0.007) and CT-IO showed increased FEV1 (+3.8 % vs. -2.5 %, p = 0.001) and FVC (+3.7 % vs. -0.7 %, p = 0.003), surgery rate: 85.7 % (lobectomy most common at 83.3 %) and no differences in complications were found except for 9 immune-mediated events in CT-IO.

Conclusions

CT-IO impacts DLCO more but improves FEV1 and FVC compared to CT. These findings warrant further validation in prospective studies.

采用联合化疗（CT）和免疫治疗（IO）是治疗非小细胞肺癌（NSCLC）的先进新辅助治疗（NA），但对功能影响的数据有限。这项多中心回顾性研究评估了接受NA治疗的非小细胞肺癌患者的呼吸功能。方法对2020 - 2024年186例接受CT或CT- io （anti-PD-1/PD-L1）治疗的患者进行分析。比较na前后的呼吸测试（DLCO、FEV1、FVC），以及临床、病理和手术变量。中位年龄：68岁；66.6%为男性；93%吸烟者/戒烟者，组织学：鳞状癌和腺癌（各占46%），CT- io的DLCO下降比CT更大（- 12.6%比- 7.8%,p = 0.007）， CT- io显示FEV1（+ 3.8%比- 2.5%,p = 0.001）和FVC（+ 3.7%比- 0.7%,p = 0.003）增加，手术率：85.7%（肺叶切除术最常见，为83.3%），除CT- io中9例免疫介导事件外，并发症无差异。结论与CT相比，sct - io对DLCO的影响更大，但能改善FEV1和FVC。这些发现值得在前瞻性研究中进一步验证。

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引用次数: 0

Comparative effectiveness of different chemotherapies given to Nodular Lymphocyte Predominant Hodgkin Lymphoma patients: A retrospective study from Lahore, Pakistan 不同化疗方案对结节性淋巴细胞显性霍奇金淋巴瘤患者的比较疗效：巴基斯坦拉合尔的回顾性研究

Q3 Medicine

Cancer treatment and research communications

Pub Date : 2025-01-01 DOI: 10.1016/j.ctarc.2025.100930

Namra Jabeen, Nazia Kanwal, Haroon Ibrahim, Aamir Amin

Nodular Lymphocyte Predominant Hodgkin Lymphoma (NLPHL) is a rare type of Hodgkin lymphoma. This retrospective study aims to find most efficient chemotherapy that gives high rates of Progression Free Survival (PFS) and overall survival (OS). In this study confirmed patients of NLPHL identified from different hospitals from 2011 to 2023. Clinical characteristics were collected from these patients to confirm NLPHL diagnosis. Eighty confirmed NLPHL patients were identified, and their median follow-up was 36 months. The median age of the participants was 35 years with minimum age of 2 years while maximum participant’s age of 70 years in which 26.1% were females while 73.8% were males. It was observed that surgery was the first line treatment given to 18.8% patients before chemotherapy and to 81.3% patients chemotherapy was the first line treatment. Patients’ chemotherapy treatments shows that 57.5% patients received ABVD, 16.3% patients with BEACOPP, while 8.8% patients received CHOP, 17.5% patients were given Rituximab-based or other treatments. According to Ann-Arbor stage*, 16.3% of the patients were of stage I, 36.3% of stage II, 27.5% of stage III and 20.0% of stage IV. Relapse was observed in 35% of the patients after chemotherapy treatment. In this study, the divergent characteristics of NLPHL treatments showed a comparatively good long-term prognosis. Mostly patients showed a good response to first line treatment. In this study, ABVD showed the best chemotherapy treatment with excellent outcomes. The overall survival demonstrated excellent initial survival rates within 5 years.

结节性淋巴细胞显性霍奇金淋巴瘤是一种罕见的霍奇金淋巴瘤。本回顾性研究旨在寻找最有效的化疗方案，以提高无进展生存率（PFS）和总生存率（OS）。本研究于2011年至2023年在不同医院确诊的NLPHL患者。收集这些患者的临床特征以确定NLPHL的诊断。80例确诊的NLPHL患者被确定，他们的中位随访时间为36个月。参与者年龄中位数为35岁，最小年龄为2岁，最大年龄为70岁，其中女性占26.1%，男性占73.8%。18.8%的患者化疗前首选手术治疗，81.3%的患者化疗前首选化疗。患者化疗情况显示，57.5%的患者接受了ABVD， 16.3%的患者接受了BEACOPP， 8.8%的患者接受了CHOP， 17.5%的患者接受了利妥昔单抗或其他治疗。根据Ann-Arbor分期*，16.3%的患者为I期，36.3%的患者为II期，27.5%的患者为III期，20.0%的患者为IV期。化疗后复发的患者占35%。在本研究中，NLPHL治疗的不同特点显示了较好的长期预后。大多数患者对一线治疗反应良好。在本研究中，ABVD是最佳的化疗方案，治疗效果良好。总体生存率在5年内表现出良好的初始生存率。

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引用次数: 0

Editorial for “Long-term oncologic outcome of intraoperative radiotherapy (IORT) with low-energy X-rays as a tumor-bed boost in Korean patients with breast cancer” 《韩国乳腺癌患者术中放疗（IORT）低能x射线促进肿瘤床的长期肿瘤预后》的社论。

IF 2.4 Q3 Medicine

Cancer treatment and research communications

Pub Date : 2025-01-01 DOI: 10.1016/j.ctarc.2025.100935

Shayan Sheikhmiri , Mostafa Robatjazi , Seyed Alireza Javadinia , Sara Shenavaei Zare , Iman Jalaimehr , Reza Chaman

引用次数: 0

A novel 9-gene classifier for predicting distant metastasis of soft-tissue sarcoma and multiple malignancies 一种预测软组织肉瘤及多发性恶性肿瘤远处转移的新型9基因分类器

IF 2.4 Q3 Medicine

Cancer treatment and research communications

Pub Date : 2025-01-01 DOI: 10.1016/j.ctarc.2025.101046

Atsushi Tanabe , Jerry Ndzinu , Hiroeki Sahara

Distant metastasis of soft tissue sarcoma (STS) is a risk factor with a significant impact on patient prognosis. Therefore, accurate prediction of STS metastatic risk is important in the therapeutic management of STS patients. In this study, we investigated gene expression profile of STS samples in public databases to comprehensively search for genes involved in distant metastasis. We then developed a 9-gene classifier that divided STS patients into four clusters with different metastatic risk. Interestingly, this classifier could also predict the metastatic risk of breast cancer, kidney clear cell carcinoma, and uveal melanoma. A comparison of AUC scores showed that the robustness of the 9-gene classifier was superior to many other existing prognostic gene signatures. In summary, the 9-gene classifier might provide useful prognostic information for the therapeutic management of STS and multiple other malignancies.

软组织肉瘤（STS）远处转移是影响患者预后的重要危险因素。因此，准确预测STS转移风险对STS患者的治疗管理具有重要意义。在本研究中，我们研究了公共数据库中STS样本的基因表达谱，以全面寻找与远处转移有关的基因。然后，我们开发了一个9基因分类器，将STS患者分为四组不同的转移风险。有趣的是，该分类器还可以预测乳腺癌、肾透明细胞癌和葡萄膜黑色素瘤的转移风险。AUC评分的比较表明，9基因分类器的稳健性优于许多其他现有的预后基因特征。总之，9基因分类器可能为STS和其他多种恶性肿瘤的治疗管理提供有用的预后信息。

引用次数: 0

A systemic review on chemotherapy induced nausea and vomiting- risk and clinical management with alternative therapies 化疗引起的恶心和呕吐的风险和替代疗法的临床管理的系统综述

Q3 Medicine

Cancer treatment and research communications

Pub Date : 2025-01-01 DOI: 10.1016/j.ctarc.2025.100938

Derangula Lavanya , VelugotlaPranathi Prasanna , Asma Firdous , Sneha Thakur

Chemotherapy-induced nausea and vomiting (CINV) affects up to 80 % of cancer patients, significantly impacts the health in terms of their quality of life and straining healthcare resources. CINV is categorized into anticipatory, acute, and delayed types. Risk factors include younger age, female sex, a history of CINV, and the emetogenic potential of the chemotherapy agents. Drugs like cisplatin and anthracycline-cyclophosphamide combinations are highly emetogenic and pose the greatest risk. Advances in managing CINV include evidence-based guidelines and the use of antiemetic medications such as 5-HT3 receptor antagonists, NK-1 receptor antagonists, and corticosteroids. These measures have reduced vomiting incidents, but complete control of nausea remains challenging. Up to 60 % of patients still experience delayed nausea, and anticipatory nausea and vomiting affect up to 30 % and 20 % of patients, respectively, by the fourth treatment cycle. Clinical and alternative therapies are though effective, research suggests integrated management for CINV. Tailored approach is needed as it has both psychological and physiological influence. To overcome the challenges, the guidelines and antiemetic regimens should be improved according to individual patient evaluation and awareness is necessary. Research is ongoing to develop targeted therapies that combine pharmacological and behavioral interventions to improve CINV management, especially for patients who do not respond well to current antiemetic treatments.

化疗引起的恶心和呕吐（CINV）影响了高达80% %的癌症患者，严重影响了他们的生活质量和紧张的医疗资源。CINV分为预期型、急性型和延迟型。危险因素包括年轻、女性、CINV病史和化疗药物的致吐潜能。顺铂和蒽环类环磷酰胺联合用药是高度致吐的，风险最大。CINV管理的进展包括循证指南和止吐药物的使用，如5-HT3受体拮抗剂、NK-1受体拮抗剂和皮质类固醇。这些措施减少了呕吐事件，但完全控制恶心仍然具有挑战性。到第四个治疗周期，高达60% %的患者仍然经历延迟性恶心，预期性恶心和呕吐分别影响高达30% %和20% %的患者。临床和替代疗法虽然有效，但研究建议对CINV进行综合管理。由于它对心理和生理都有影响，因此需要量身定制的方法。为了克服这些挑战，指南和止吐方案应根据个别患者的评估和必要的认识进行改进。研究正在开发结合药理学和行为干预的靶向治疗方法，以改善CINV的管理，特别是对目前止吐治疗反应不佳的患者。

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引用次数: 0

Paclitaxel resistance in breast cancer: Current challenges and recent advanced therapeutic strategies 乳腺癌紫杉醇耐药：当前的挑战和最新的先进治疗策略

Q3 Medicine

Cancer treatment and research communications

Pub Date : 2025-01-01 DOI: 10.1016/j.ctarc.2025.100918

Heidi A. Abouzeid , Loay Kassem , Xuemei Liu , Ahmed Abuelhana

Breast cancer (BC) is one of the leading causes of cancer-related deaths among women worldwide. Paclitaxel (PTX), a chemotherapeutic agent derived from the taxane family, is commonly used in treating BC due to its ability to disrupt microtubule dynamics and induce cell death. However, resistance to PTX presents a significant challenge, as it diminishes the drug's effectiveness and can lead to treatment failure. This review explores the mechanisms by which PTX exerts its effects and the various factors contributing to resistance. These factors include genetic mutations that affect tubulin dynamics, the role of non-coding RNAs, molecular pathways involved in chemoresistance, epigenetic changes, post-transcriptional modifications, increased activity of ABC transporters that promote drug efflux, immunosuppressive interactions within the tumor microenvironment, and resistance mediated by autophagy. This review also explores strategies to overcome PTX resistance, including molecular and genetic innovations, combination therapies, and nanotechnology-based approaches. These strategies may improve PTX efficacy and enhance treatment outcomes for BC patients.

乳腺癌（BC）是全世界妇女癌症相关死亡的主要原因之一。紫杉醇（PTX）是紫杉烷家族的一种化疗药物，由于其破坏微管动力学和诱导细胞死亡的能力，通常用于治疗BC。然而，对PTX的耐药性提出了一个重大挑战，因为它降低了药物的有效性，并可能导致治疗失败。本文综述了PTX的作用机制以及导致耐药的各种因素。这些因素包括影响微管蛋白动力学的基因突变、非编码rna的作用、参与化学耐药的分子途径、表观遗传变化、转录后修饰、促进药物外排的ABC转运蛋白活性增加、肿瘤微环境内免疫抑制相互作用以及自噬介导的耐药。本文还探讨了克服PTX耐药的策略，包括分子和遗传创新、联合治疗和基于纳米技术的方法。这些策略可以提高PTX的疗效，提高BC患者的治疗效果。

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