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Heliyon Jun 2024TNFRSF4 plays a significant role in cancer progression, especially in hepatocellular carcinoma (HCC). This study aims to investigate the prognostic value of TNFRSF4...
BACKGROUND
TNFRSF4 plays a significant role in cancer progression, especially in hepatocellular carcinoma (HCC). This study aims to investigate the prognostic value of TNFRSF4 expression in patients with HCC and to develop a predictive pathomics model for its expression.
METHODS
A cohort of patients with HCC retrieved from the TCGA database was analyzed using RNA-seq analysis to determine TNFRSF4 expression and its impact on overall survival (OS). Additionally, hematoxylin-eosin staining analysis was performed to construct a pathomics model for predicting TNFRSF4 expression. Then, pathway enrichment analysis was conducted, immune checkpoint markers were investigated, and immune cell infiltration was examined to explore the underlying biological mechanism of the pathomics score.
RESULTS
TNFRSF4 expression was significantly higher in tumor tissues than in normal tissues. TNFRSF4 expression also exhibited significant correlations with various clinical variables, including pathologic stage III/IV and R1/R2/RX residual tumor. Furthermore, elevated TNFRSF4 expression was associated with unfavorable OS. Interestingly, in the subgroup analysis, elevated TNFRSF4 expression was identified as a significant risk factor for OS in male patients. The newly developed pathomics model successfully predicted TNFRSF4 expression with good performance and revealed a significant association between high pathomics scores and worse OS. In male patients, high pathomics scores were also associated with a higher risk of mortality. Moreover, pathomics scores were also involved in specific hallmarks, immune-related characteristics, and apoptosis-related genes in HCC, such as epithelial-mesenchymal transition, Tregs, and BAX expression.
CONCLUSIONS
Our findings suggest that TNFRSF4 expression and the newly devised pathomics scores hold potential as prognostic markers for OS in patients with HCC. Additionally, gender influenced the association between these markers and patient outcomes.
PubMed: 38841483
DOI: 10.1016/j.heliyon.2024.e31882 -
Surgical Neurology International 2024Schwannoma is a typically benign nerve sheath tumor. Here, a 30-year-old female underwent resection of a benign retroperitoneal/intra/paraspinal schwannoma.
BACKGROUND
Schwannoma is a typically benign nerve sheath tumor. Here, a 30-year-old female underwent resection of a benign retroperitoneal/intra/paraspinal schwannoma.
CASE DESCRIPTION
A 30-year-old female originally had urological surgery to remove an ill-defined retroperitoneal tumor. When she newly presented with right-side low back pain, and the magnetic resonance documented a recurrent/residual L1-L3 intra/paraspinal lesion, she required an additional tumor excision for the removal of the benign schwannoma.
CONCLUSION
Spinal surgeons, dealing with benign schwannomas located in the retroperitoneal/intra/paraspinal compartments, need to work collaboratively with other surgeons (i.e., in this case, urologists) to achieve gross total tumor excision, and the best long-term results.
PubMed: 38840621
DOI: 10.25259/SNI_267_2024 -
Trends in Cancer Jun 2024Systemic treatment of resectable non-small cell lung cancer (NSCLC) is evolving with emerging neoadjuvant, perioperative, and adjuvant immunotherapy approaches.... (Review)
Review
Systemic treatment of resectable non-small cell lung cancer (NSCLC) is evolving with emerging neoadjuvant, perioperative, and adjuvant immunotherapy approaches. Circulating tumor DNA (ctDNA) detection at clinical diagnosis, during neoadjuvant therapy, or after resection may discern high-risk patients who might benefit from therapy escalation or switch. This Review summarizes translational implications of data supporting ctDNA-based risk determination in NSCLC and outstanding questions regarding ctDNA validity/utility as a prognostic biomarker. We discuss emerging ctDNA capabilities to refine clinical tumor-node-metastasis (TNM) staging in lung adenocarcinoma, ctDNA dynamics during neoadjuvant therapy for identifying patients deriving suboptimal benefit, and postoperative molecular residual disease (MRD) detection to escalate systemic therapy. Considering differential relapse characteristics in landmark MRD-negative/MRD-positive patients, we propose how ctDNA might integrate with pathological response data for optimal postoperative risk stratification.
PubMed: 38839544
DOI: 10.1016/j.trecan.2024.04.004 -
Journal of Cancer Research and Clinical... Jun 2024The neoadjuvant chemotherapy (NACT) regimen for triple negative breast cancer (TNBC) primarily consists of anthracyclines and taxanes, and the addition of platinum-based... (Comparative Study)
Comparative Study
Comparison of the efficacy of taxanes with carboplatin and anthracyclines with taxanes in neoadjuvant chemotherapy for stage II-III triple negative breast cancer: a retrospective analysis.
PURPOSE
The neoadjuvant chemotherapy (NACT) regimen for triple negative breast cancer (TNBC) primarily consists of anthracyclines and taxanes, and the addition of platinum-based drugs can further enhance the efficacy. However, it is also accompanied by more adverse events, and considering the potential severe and irreversible toxicity of anthracyclines, an increasing number of studies are exploring nonanthracycline regimens that combine taxanes and platinum-based drugs.
METHODS
The retrospective study included 273 stage II-III TNBC patients who received NACT. The AT group, consisting of 195 (71.4%) patients, received a combination of anthracyclines and taxanes, while the TCb group, consisting of 78 (28.6%) patients, received a combination of taxanes and carboplatin. Logistic regression analysis was performed to evaluate the factors influencing pathological complete response (pCR) and residual cancer burden (RCB). The log-rank test was used to assess the differences in event-free survival (EFS) and overall survival (OS) among the different treatment groups. Cox regression analysis was conducted to evaluate the factors influencing EFS and OS.
RESULTS
After NACT and surgery, the TCb group had a higher rate of pCR at 44.9%, as compared to the AT group at 31.3%. The difference between the two groups was 13.6% (OR = 0.559, 95% CI 0.326-0.959, P = 0.035). The TCb group had a 57.7% rate of RCB 0-1, which was higher than the AT group's rate of 42.6%. The difference between the two groups was 15.1% (OR = 0.543, 95% CI 0.319-0.925, P = 0.024), With a median follow-up time of 40 months, the TCb group had better EFS (log-rank, P = 0.014) and OS (log-rank, P = 0.040) as compared to the AT group. Clinical TNM stage and RCB grade were identified as independent factors influencing EFS and OS, while treatment group was identified as an independent factor influencing EFS, with a close-to-significant impact on OS.
CONCLUSION
In stage II-III triple TNBC patients, the NACT regimen combining taxanes and carboplatin yields higher rates of pCR and significant improvements in EFS and OS as compared to the regimen combining anthracyclines and taxanes.
Topics: Humans; Triple Negative Breast Neoplasms; Female; Retrospective Studies; Carboplatin; Anthracyclines; Neoadjuvant Therapy; Middle Aged; Antineoplastic Combined Chemotherapy Protocols; Adult; Taxoids; Aged; Neoplasm Staging
PubMed: 38836955
DOI: 10.1007/s00432-024-05738-x -
Cureus May 2024An esophagobronchial fistula, an abnormal passageway formed between the esophagus and bronchus, can cause severe respiratory symptoms. This fistula is a complication...
An esophagobronchial fistula, an abnormal passageway formed between the esophagus and bronchus, can cause severe respiratory symptoms. This fistula is a complication that can occur during chemoradiotherapy for esophageal and lung cancers; however, to our knowledge, no esophagobronchial fistulas during preoperative chemotherapy for lung cancer have been reported. The patient was a 55-year-old man whose chest computed tomography (CT) revealed a mass on the dorsal bronchus and right side of the esophagus. A transesophageal needle biopsy confirmed the diagnosis of lung adenocarcinoma, and preoperative chemotherapy, which included pembrolizumab, was administered. One week after the first course of chemotherapy, the patient developed a severe cough after drinking water. Chest CT revealed an esophagobronchial fistula, which prompted the discontinuation of the preoperative chemotherapy. Subsequent conservative treatment resulted in no improvement, and the patient was referred to our department. One month thereafter, a two-stage reconstruction of the esophagus was performed via the posterior sternal route. The resected specimen showed no residual tumor in the lungs, and the treatment was determined to result in a complete pathological response. The patient is currently undergoing maintenance therapy with pembrolizumab as a single agent. This is a rare case of esophagobronchial fistula identified during preoperative chemotherapy that included pembrolizumab for lung cancer. In addition to suturing the fistula, filling it with a distal hyoid valve was effective in treating the esophagobronchial fistula.
PubMed: 38836156
DOI: 10.7759/cureus.59666 -
Medizinische Genetik : Mitteilungsblatt... Dec 2023This narrative review aims to provide a comprehensive overview of the current state of circulating tumor cell (CTC) analysis and its clinical significance in patients...
This narrative review aims to provide a comprehensive overview of the current state of circulating tumor cell (CTC) analysis and its clinical significance in patients with epithelial cancers. The review explores the advancements in CTC detection methods, their clinical applications, and the challenges that lie ahead. By examining the important research findings in this field, this review offers the reader a solid foundation to understand the evolving landscape of CTC analysis and its potential implications for clinical practice. The comprehensive analysis of CTCs provides valuable insights into tumor biology, treatment response, minimal residual disease detection, and prognostic evaluation. Furthermore, the review highlights the potential of CTCs as a non-invasive biomarker for personalized medicine and the monitoring of treatment efficacy. Despite the progress made in CTC research, several challenges such as standardization, validation, and integration into routine clinical practice remain. The review concludes by discussing future directions and the potential impact of CTC analysis on improving patient outcomes and guiding therapeutic decision-making in epithelial cancers.
PubMed: 38835741
DOI: 10.1515/medgen-2023-2056 -
Medizinische Genetik : Mitteilungsblatt... Dec 2023Genetic predisposition is one of the major measurable cancer risk factors. Affected patients have an enhanced risk for cancer and require life-long surveillance....
Genetic predisposition is one of the major measurable cancer risk factors. Affected patients have an enhanced risk for cancer and require life-long surveillance. However, current screening measures are mostly invasive and only available for certain tumor types. Particularly in hereditary cancer syndromes, liquid biopsy, in addition to monitoring therapy response and assessing minimal residual disease, holds great potential for surveillance at the precancerous stage and potentially even diagnostics. Exploring these options and future clinical translation could help reduce cancer risk and mortality in high-risk individuals and enhance patients' adherence to tailored surveillance protocols.
PubMed: 38835740
DOI: 10.1515/medgen-2023-2049 -
Journal of Obstetrics and Gynaecology :... Dec 2024At present, the discovery of new biomarkers is of great significance for the early diagnosis, treatment and prognosis assessment of ovarian cancer. Previous findings...
BACKGROUND
At present, the discovery of new biomarkers is of great significance for the early diagnosis, treatment and prognosis assessment of ovarian cancer. Previous findings indicated that aberrant G-protein-coupled receptor 176 (GPR176) expression might contribute to tumorigenesis and subsequent progression. However, the expression of GPR176 and the molecular mechanisms in ovarian cancer had not been investigated.
METHODS
GPR176 expression was compared with clinicopathological features of ovarian cancer using immunohistochemical and bioinformatics analyses. GPR176-related genes and pathways were analysed using bioinformatics analysis. Additionally, the effects of GPR176 on ovarian cancer cell phenotypes were investigated.
RESULTS
GPR176 expression positively correlated with elder age, clinicopathological staging, tumour residual status, and unfavourable survival of ovarian cancer, but negatively with purity loss, infiltration of B cells, and CD8+ T cells. Gene Set Enrichment Analysis showed that differential expression of GPR176 was involved in focal adhesion, ECM-receptor interaction, cell adhesion molecules and so on. STRING and Cytoscape were used to determine the top 10 nodes. Kyoto Encyclopaedia of Genes and Genomes analysis indicated that GPR176-related genes were involved in the ECM structural constituent and organisation and so on. GPR176 overexpression promoted the proliferation, anti-apoptosis, anti-pyroptosis, migration and invasion of ovarian cancer cells with overexpression of N-cadherin, Zeb1, Snail, Twist1, and under-expression of gasdermin D, caspase 1, and E-cadherin.
CONCLUSION
GPR176 might be involved in the progression of ovarian cancer. It might be used as a biomarker to indicate the aggressive behaviour and poor prognosis of ovarian cancer and a target of genetic therapy.
Topics: Humans; Female; Receptors, G-Protein-Coupled; Ovarian Neoplasms; Middle Aged; Genetic Therapy; Gene Expression Regulation, Neoplastic; Cell Line, Tumor; Biomarkers, Tumor; Computational Biology; Prognosis; Cell Proliferation; Carcinogenesis; Zinc Finger E-box-Binding Homeobox 1
PubMed: 38835234
DOI: 10.1080/01443615.2024.2347430 -
PloS One 2024Neoadjuvant chemotherapy (NACT) is a treatment option for breast cancer patients that allows for the assessment of tumor response during treatment. This information can... (Comparative Study)
Comparative Study
BACKGROUND
Neoadjuvant chemotherapy (NACT) is a treatment option for breast cancer patients that allows for the assessment of tumor response during treatment. This information can be used to adjust treatment and improve outcomes. However, the optimal imaging modalities and parameters for assessing tumor response to NACT are not well established.
METHODS
This study included 173 breast cancer patients who underwent NACT. Patients were imaged with ultrasound (US), mammography (MMG), and magnetic resonance imaging (MRI) at baseline, after two cycles of NACT, and before breast surgery. US parameters included lesion morphology, Doppler variables, and elastography measurements. MMG and MRI were evaluated for the presence of nodules and tumor dimensions. The pathological response to NACT was determined using the residual cancer burden (RCB) classification.
RESULTS
The US parameter with the highest power for predicting pathological complete response (pCR) was shear wave elastography (SWE) maximum speed inside the tumor at baseline. For nonluminal tumors, the end diastolic velocity measured by US after two cycles of NACT showed the highest predictive value for pCR. Similarly, SWE maximum speed after two cycles of NACT had the highest discriminating power for predicting RCB-III in luminal tumors, while the same parameter measured at baseline was most predictive for nonluminal tumors.
CONCLUSIONS
This study provides evidence that mid-treatment Doppler US and other imaging modalities can be used to predict the response to NACT in breast cancer patients. Functional parameters, such as blood flow velocities and SWE measurements, demonstrated superior predictive value for pCR, while morphological parameters had limited value. These findings have implications for personalized treatment strategies and may contribute to improved outcomes in the management of breast cancer.
Topics: Humans; Breast Neoplasms; Female; Neoadjuvant Therapy; Middle Aged; Magnetic Resonance Imaging; Mammography; Adult; Prospective Studies; Aged; Ultrasonography, Doppler; Elasticity Imaging Techniques; Predictive Value of Tests; Treatment Outcome
PubMed: 38833499
DOI: 10.1371/journal.pone.0302527 -
JAMA Network Open Jun 2024Treatment of locally advanced rectal cancer (LARC) involves neoadjuvant chemoradiotherapy plus total mesorectal excision and adjuvant chemotherapy. However, total... (Meta-Analysis)
Meta-Analysis
IMPORTANCE
Treatment of locally advanced rectal cancer (LARC) involves neoadjuvant chemoradiotherapy plus total mesorectal excision and adjuvant chemotherapy. However, total neoadjuvant therapy (TNT) protocols (ie, preoperative chemotherapy in addition to radiotherapy) may allow better adherence and early treatment of distant micrometastases and may increase pathological complete response (pCR) rates.
OBJECTIVE
To assess the efficacy and tolerability of TNT protocols for LARC.
DATA SOURCES
MEDLINE, Embase, Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science Core Collection electronic databases and ClinicalTrials.gov for unpublished studies were searched from inception to March 2, 2024.
STUDY SELECTION
Randomized clinical trials including adults with LARC who underwent rectal resection as a final treatment were included. Studies including nonoperative treatment (watch-and-wait strategy), treatments other than rectal resection, immunotherapy, or antiangiogenic agents were excluded. Among the initially identified studies, 2.9% met the selection criteria.
DATA EXTRACTION AND SYNTHESIS
Two authors independently screened the records and extracted data. Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA)-compliant pairwise and network meta-analyses with a random-effects model were performed in a frequentist framework, and the certainty of evidence was assessed according to the confidence in network meta-analysis approach.
MAIN OUTCOMES AND MEASURES
The primary outcome was pCR, defined as the absence of residual tumor at pathological assessment after surgery. Secondary outcomes included tolerability, toxic effects, perioperative outcomes, and long-term survival.
RESULTS
Of 925 records identified, 27 randomized clinical trials, including 13 413 adults aged 18 years or older (median age, 60.0 years [range, 42.0-63.5 years]; 67.2% male) contributed to the primary network meta-analysis. With regard to pCR, long-course chemoradiotherapy (L-CRT) plus consolidation chemotherapy (relative risk [RR], 1.96; 95% CI, 1.25-3.06), short-course radiotherapy (S-RT) plus consolidation chemotherapy (RR, 1.76; 95% CI, 1.34-2.30), and induction chemotherapy plus L-CRT (RR, 1.57; 95% CI, 1.09-2.25) outperformed standard L-CRT with single-agent fluoropyrimidine-based chemotherapy. Considering 3-year disease-free survival, S-RT plus consolidation chemotherapy (RR, 1.08; 95% CI, 1.01-1.14) and induction chemotherapy plus L-CRT (RR, 1.12; 95% CI, 1.01-1.24) outperformed L-CRT, in spite of an increased 5-year locoregional recurrence rate of S-RT plus consolidation chemotherapy (RR, 1.65; 95% CI, 1.03-2.63).
CONCLUSIONS AND RELEVANCE
In this systematic review and network meta-analysis, 3 TNT protocols were identified to outperform the current standard of care in terms of pCR rates, with good tolerability and optimal postoperative outcomes, suggesting they should be recognized as first-line treatments.
Topics: Rectal Neoplasms; Humans; Neoadjuvant Therapy; Network Meta-Analysis; Female; Middle Aged; Male; Randomized Controlled Trials as Topic; Adult
PubMed: 38833249
DOI: 10.1001/jamanetworkopen.2024.14702