Cancers最新文献

Background: Hypoxia-inducible factor-1α (HIF-1α) is a well-known transcriptional regulator that mediates a broad spectrum of cellular responses to hypoxia, including angiogenesis, extracellular matrix remodeling, and metabolic reprogramming. These activities can be achieved by upregulation of numerous genes, such as vascular endothelial growth factors, fibroblast growth factors, and platelet-derived growth factors, which are involved in the growth regulation of normal tissues and solid tumors. Notably, HIF-1α-mediated regulation of the solid tumor's microenvironment effectively modulates tumor sensitivity to anticancer therapies and thereby can contribute to disease progression. Methods: The study was performed on breast, lung and prostate cancer cell lines. Protein expression was examined by western blotting. Antitumor activity of 2-ANPC was measured by syngeneic 4T1 breast cancer mouse model. Results: We show here that a 2-aminopyrrole derivative (2-amino-1-benzamido-5-(2-(naphthalene-2-yl)-2-oxoethylidene)-4-oxo-4,5-dihydro-1-H-pyrrole-3-carboxamide-2-ANPC), previously shown as a potent microtubule-targeting agent, effectively downregulates HIF-1α expression in a broad spectrum of cancer cell lines, including breast, lung, and prostate cancer. The downregulation of HIF-1α expression in 2-ANPC-treated cancer cells was due to enhanced proteasome-mediated degradation, whereas the proteasome inhibitor MG-132 effectively reversed this downregulation. 2-ANPC's potency in downregulating HIF-1α was also shown in vivo by using the 4T1 breast cancer syngraft model. Importantly, this 2-aminopyrrole derivative also downregulated the expression of vascular endothelial growth factor receptors 1 and 3 (VEGFR1 and 3) in 4T1 tumors, which correlated with decreased tumor weight and size. As expected, an increase in apoptotic (i.e., cleaved caspase-3-positive) cells was detected in 4T1 tumors treated with 2-aminopyrrole derivative. Lastly, using various computational tools, we identified four potential binding sites for 2-ANPC to interact with HIF-1α, HIF-1β, and the p300 complex. Conclusions: Collectively, we show here, for the first time, that HIF-1α is a novel molecular target for the 2-aminopyrrole derivative (2-ANPC), thereby illustrating it as a potential scaffold for the development of potent chemotherapeutic agents with anti-angiogenic activity.

Carbon ion radiation therapy (CIRT) is a high-LET radiotherapy, which distinguishes itself from traditional low-LET radiation, such as photons and protons, through its unique physical aspects, biological attributes, and the dramatically increased damage it causes within cellular DNA. Given its distinctive characteristics, it is expected to improve the therapeutic ratio of radiation treatments and enhance treatment outcomes in traditionally radiation-resistant tumor histologies. Despite these unique properties, much remains to be understood regarding the clinical use of CIRT before its full potential can be realized. In this review, we summarize the distinct advantages of CIRT with regard to its physical and biological qualities and discuss the possibilities for novel applications of this technology through the exploitation of its immunomodulatory potential, abscopal impacts, and its ability to generate direct, oxygen-independent radiation damage within treated tumors.

Background/objectives: Uveal melanoma is a rare but aggressive intraocular malignancy that metastasizes in up to half of patients, most commonly to the liver, despite effective local treatment. In the absence of robust evidence, there are no standardized guidelines for post-treatment surveillance, resulting in wide variation in imaging modalities, frequency, and duration across physicians and institutions. This study aimed to develop expert consensus recommendations for surveillance strategies in patients with uveal melanoma.

Methods: A modified Delphi method was conducted across three iterative survey rounds between September 2024 and February 2025 using an online platform. Panelists included medical oncologists, ocular oncologists, radiologists, and surgical oncologists from North America. A multidisciplinary steering committee developed statements addressing risk-based surveillance using both molecular and clinical prognostic factors, including gene expression profiling (GEP) and PRAME status. Consensus was defined a priori as ≥70% of panelists rating a statement 7-9 on a 9-point Likert scale.

Results: Forty-nine experts were invited, and 41 completed at least one survey round. The panel represented 17 U.S. states, Washington, D.C., and two Canadian provinces. Twelve statements reached stable consensus, including recommendations for imaging modality, frequency, and duration in intermediate- and high-risk patients. Although there was agreement that low-risk patients warrant surveillance, no consensus was reached on the optimal approach for this group.

Conclusions: This is the first study to provide consensus-based guidance incorporating GEP and PRAME status into surveillance recommendations for uveal melanoma, offering a standardized framework to guide clinical practice and future research.

The journal retracts the article, "The Brain Penetrating and Dual TORC1/TORC2 Inhibitor, RES529, Elicits Anti-Glioma Activity and Enhances the Therapeutic Effects of Anti-Angiogenetic Compounds in Preclinical Murine Models" [...].

Background: Upper tract urothelial carcinoma (UTUC) is a rare malignancy with limited epidemiological data from Central and Eastern Europe. This study aimed to evaluate long-term trends in UTUC incidence, mortality, and survival in Poland and to compare them with other European countries. Methods: Incidence and mortality data were acquired from Polish National Cancer Registry, Statistics Poland and European Cancer Information System. Age-standardized incidence and mortality rates were calculated using the European Standard Population (ESP 2013). Temporal trends were assessed using Joinpoint regression, and five-year relative survival was estimated with the Pohar-Perme method. Results: Our study demonstrated significantly higher incidence and mortality rates of UTUC across Europe compared to the initial observation period, consistent with the data from Poland. UTUC incidence increased in Poland between 2000 and 2017 (average annual percent change [AAPC] 5.6% in women and 9.9% in men), followed by a decline among women after 2017 (AAPC -1.3%). Mortality initially rose in both sexes but decreased in recent years, particularly in men (AAPC -5.47%). Renal pelvis cancer showed higher incidence and mortality than ureteral cancer. Compared with other European countries, Poland exhibited a smaller gap between incidence and mortality. Five-year relative survival improved over time, reaching 55-56% for renal pelvis cancer and up to 62% for ureteral cancer. Conclusions: UTUC incidence and mortality are rising in Europe, but Poland displays a distinctive epidemiological pattern. Strengthening national cancer registries and implementing centralized care protocols may improve disease management and reduce mortality.

Dendritic cells (DCs) are a heterogeneous population known for antigen presentation and immune modulation, playing a key role in priming a T cell response against pathogens and tumor cells. Despite their putative therapeutic value, their scarcity in peripheral blood limited their direct use in therapeutic applications until recently. The discovery that DCs can be generated from circulating monocytes ex vivo, however, gave a boost of extensive research in the use of DCs in clinical applications. Still, despite the numerous clinical trials, the introduction of DCs in the everyday clinical oncology practice is delayed. In this narrative review, we provide an updated summary of the field covering the theoretical and practical aspects of the concept of the use of DCs in adoptive cellular immunotherapy and the completed or ongoing clinical trials for the use of these species in clinical oncology practice. To better understand the current developments of the field, we included those clinical trial reports that published evaluable data to date. Based on our literature survey, DC-based adoptive cellular therapy is a safe therapeutic intervention with valuable clinical potential. Its widespread implementation, however, is likely delayed due to a number of factors that make meaningful evaluation of clinical trial results complicated. These include the great variety of preclinical trial concepts, difficult and heterogenous patient cohorts, and the diversity of intervention techniques applied. Since these factors might hinder the routine implementation of DC-based applications in the more widespread forms of immunotherapy, one of the urgent short-term future directions seems to be the standardization of the DC-based methodologies.

Background/objectives: Understanding the immune landscape in cervical cancer is critical to the development of improved therapeutics. This study investigated the immune microenvironment in early-stage cervical cancer with a focus on B and T cell immune aggregates, i.e., lymphoid aggregates (LAs) and tertiary lymphoid structures (TLSs). Methods: Using multispectral imaging, we interrogated a cohort of patients with clinical stage I squamous or adenocarcinoma of the cervix with a focus on T and B cell spatial location and organization. Despite early-stage disease, recurrence was common at 37%, highlighting the need to identify patients at high risk for recurrence. Results: We demonstrated that high CD8+ T cell infiltration correlated significantly with improved overall survival (OS), particularly in patients with adenocarcinoma histology. CD8+ T cells colocalized with B cells, suggesting the formation of a more sophisticated cellular neighborhood, i.e., TLS, which has prognostic benefit in other solid tumors. CXCL13, a chemokine associated with TLS formation, correlated with improved recurrence-free survival. The combination of high CXCL13 and lymphoid structures correlated with improved OS. However, most immune structures in cervical cancer were lymphoid aggregates (LAs) that lack features of more developed TLS, such as high endothelial venules (HEVs) and germinal centers (GCs), highlighting a lack of full immune activation in this microenvironment. Validation in The Cancer Genome Atlas (TCGA) cohort illustrated similar trends in survival. Conclusions: Collectively, this work demonstrates the prognostic significance of immune infiltration and eventual TLS induction in early cervical cancer and presents potential future therapeutic targets.

Axillary management in early-stage, HER2-negative, hormone receptor-positive breast cancer has undergone major changes in recent years. While axillary lymph node dissection (ALND) was once considered essential for staging and regional control, increasing evidence supports the safety of surgical de-escalation in selected patients. At the same time, systemic therapies such as CDK4/6 and PARP inhibitors rely on nodal burden to define eligibility, raising new challenges in balancing oncologic benefit with treatment-related morbidity. This narrative review summarizes current strategies in axillary management for patients undergoing upfront surgery for HR-positive, HER2-negative early breast cancer. It explores the role of sentinel lymph node biopsy (SLNB), the indications for ALND, the integration of adjuvant systemic therapy, and the emerging role of radiotherapy and predictive tools in guiding individualized treatment decisions. Key randomized trials including Z0011, AMAROS, SENOMAC, SOUND, and INSEMA have demonstrated that omission of ALND is safe in patients with limited nodal involvement, especially when combined with whole-breast or regional nodal radiotherapy. However, trials such as MonarchE and OlympiA have introduced systemic therapies whose indications are closely tied to nodal status, prompting reconsideration of the extent of axillary staging. Advances in imaging and risk stratification tools offer new avenues for safely limiting surgical intervention while preserving access to systemic options. In conclusion, modern axillary management in HR-positive, HER2-negative breast cancer involves navigating the intersection between de-escalated surgery and risk-adapted systemic therapy. Future strategies should prioritize individualized care, incorporating tumor biology, imaging findings, and patient preferences, with multidisciplinary collaboration playing a central role in optimizing outcomes.

Introduction: Patients with malignant glioma are inherently at high risk of venous thromboembolism (VTE) and bleeding, and systemic therapy may further modify this vascular risk. This study used large spontaneous reporting databases to compare VTE, central nervous system (CNS) bleeding and gastrointestinal (GI) bleeding signals associated with four representative systemic therapies for glioma-temozolomide, bevacizumab and the nitrosourea alkylating agents lomustine and carmustine-and explore bevacizumab-based combination regimens. Methods: We conducted a retrospective pharmacovigilance study using the FAERS and the CVARD, identifying reports of patients with gliomas exposed to temozolomide, bevacizumab, lomustine or carmustine. VTE, CNS bleeding and GI bleeding were defined a priori, and disproportionality was assessed using reporting odds ratios (RORs) with 95% confidence intervals (CIs); a positive signal was defined as a ≥ 3 and a 95% CI lower bound > 1. In bevacizumab-exposed patients, we compared bevacizumab monotherapy with bevacizumab + temozolomide and bevacizumab + lomustine treatments and performed sensitivity analyses on a stricter glioma cohort. Results: Bevacizumab was the only drug that consistently showed positive signals for VTE and GI bleeding, whereas temozolomide showed no clear VTE signal, and nitrosourea agents yielded only sparse, unstable increases. Bevacizumab + temozolomide regimens had higher RORs for VTE and GI bleeding than bevacizumab alone, while bevacizumab + lomustine showed only modest VTE increases and no robust bleeding signals. Conclusions: In real-world pharmacovigilance data, bevacizumab-containing therapy, particularly when combined with temozolomide, carries the greatest disproportionate burden of VTE and GI bleeding among common systemic treatments for malignant glioma, whereas temozolomide alone appears largely neutral, and current evidence supporting nitrosourea-related signals remains inconclusive.

Objective: To develop and validate an interpretable deep learning model based on the TabNet architecture for predicting doxorubicin-induced cardiotoxicity (DIC) in patients with breast cancer through integration of multidimensional clinical data. Methods: This retrospective study included 2034 patients who received doxorubicin-based chemotherapy at The Fourth Affiliated Hospital of Harbin Medical University between January 2021 and December 2023. Clinical, biochemical, electrocardiographic, and echocardiographic parameters were incorporated into six predictive algorithms: logistic regression, decision tree, random forest, gradient boosting machine, XGBoost, and TabNet. Model discrimination, calibration, and clinical utility were assessed using AUC, C-index, calibration plots, and decision curve analysis. Model interpretability was evaluated through attention-based feature importance and SHAP analysis. Results: TabNet achieved the best overall predictive performance, with an AUC of 0.86 and a C-index of 0.80 in the validation cohort, demonstrating superior discrimination, calibration, and generalization compared with all baseline models. Decision curve analysis confirmed its higher net clinical benefit across threshold probabilities. The model identified eight dominant predictors-cumulative anthracycline dose, LVEF, QTc interval, lactate dehydrogenase, creatinine, glucose, hypertension, and platelet count-that collectively reflected myocardial contractility, electrophysiological stability, and systemic metabolic stress. Correlation and clustering analyses revealed that high-risk patients exhibited concurrent QTc prolongation, metabolic disturbance, and LVEF decline, defining a distinct cardiometabolic injury phenotype. These findings highlight TabNet's ability to uncover complex feature interactions while maintaining transparent and clinically interpretable outputs. Conclusions: The TabNet-based multidimensional model provides an accurate, stable, and interpretable tool for individualized prediction of doxorubicin-induced cardiotoxicity, supporting early intervention and precision management in breast cancer patients receiving anthracycline therapy.