Effects of postoperative treatment with chemotherapy and cellular immunotherapy on patients with colorectal cancer.

ObjectiveTo investigate the prognostic value of preoperative body composition and serum tumor markers (STM) in patients undergoing surgical treatment for colorectal cancer (CRC) and to establish the prognostic score for patients with CRC.MethodsThis study enrolled 365 patients (training set 245, validation set 120) with CRC who underwent surgical resection. The predictive value of various body composition features and STM for determining CRC prognosis were compared. A novel index score based on the independent risk factors from Cox regression for CRC patients was established and evaluated for its usefulness.ResultsMultivariate Cox regression showed that low skeletal muscle radiodensity (SMD) (p = 0.020), low subcutaneous fat area (SFA) (p = 0.029), high carcinoembryonic antigen (CEA) (p = 0.008), and high alpha-fetoprotein (AFP) (p = 0.039) were all independent prognostic factors for poor overall survival (OS). The multifactorial analysis indicated that high intermuscular fat area (IMFA) (p = 0.033) and high CEA (p = 0.009) were independent prognostic factors for poor disease-free survival (DFS). Based on these findings, two scoring systems for OS and DFS were established in the training datasets. CRC patients who scored higher on the new scoring systems had lower OS and DFS (both p < 0.001) as shown in the Kaplan–Meier survival curves in the training and validation datasets.ConclusionIn predicting the prognosis of CRC patients, SFA and SMD are superior to other body composition measurements. A scoring system based on body composition and STM can have prognostic value and clinical applicability.Clinical relevance statementThis scoring system, combining body composition and serum tumor markers, may help predict postoperative survival of CRC patients and help clinicians make well-informed decisions regarding the treatment of patients.Key PointsColorectal cancer prognosis can be related to body composition.High intermuscular fat area and CEA were independent prognostic factors for poor disease-free survival.This scoring system, based on body composition and tumor markers, can prognosticate for colorectal cancer patients.

To evaluate the clinical efficacy of programmed death-1 (PD-1) inhibitor therapy combined with argon-helium cryoablation in patients with non-small cell lung cancer (NSCLC). A total of 108 NSCLC patients were enrolled. The control group included 52 patients who received PD-1 inhibitor monotherapy, while 56 patients received combination therapy with PD-1 inhibitors and argon-helium cryoablation (research group). Treatment efficacy, incidence of adverse events, serum tumor marker levels (carcinoembryonic antigen, cytokeratin fragment 19), and humoral immune function (immunoglobulin (Ig) G, IgM, and IgA), and quality of life (as measured by the Karnofsky Performance Status [KPS]) were compared between the two groups. Independent predictors of treatment response were identified through univariate analysis followed by binary logistic regression. A nomogram was subsequently developed to visualize the risk of treatment failure. Although the incidence of adverse events was comparable between groups (P>0.05), the research group demonstrated a significantly higher overall response rate (P<0.05). Post-treatment analyses revealed significant reductions in serum tumor markers and increases in immunoglobulin levels and KPS scores in the research group (all P<0.05). Logistic regression identified age ≥55 years (odds ratio [OR]: 2.427) and tumor diameter ≥6.00 cm (OR: 3.394) as independent predictors of poor treatment response (all P<0.05). The nomogram model exhibited moderate discriminative ability, though calibration suggested a tendency to overestimate response rates in the low-risk subgroup. PD-1 inhibitor therapy combined with argon-helium cryoablation offers a promising and effective treatment strategy for patients with NSCLC.

Serum tumor markers and computed tomography (CT) are the most widely accepted monitoring tools for the follow-up patients with colorectal cancer (CRC). Positron emission tomography (PET) with 18[F]-fluorodeoxyglucose (FDG) is a promising modality for the evaluation of recurrent CRC. The purpose of this study was to (1) investigate the sensitivity and specificity of serum tumor marker assay, CT and FDG PET-CT, (2) determine the correlation of these markers with FDG PET-CT quantitative indices such as maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV) and total lesion glycolysis (TLG) in patients suspected to have recurrent CRC. FDG PET-CT imaging was performed in 212 patients with possible CRC recurrence. A retrospective study was performed on patients with (1) a history of CRC with complete remission after treatment, (2) pathology of adenocarcinoma and (3) increase in cancer antigen 19-9 (CA 19-9) and/or carcinoembryonic antigen (CEA) or suspicious radiological evaluation during follow-up after complete remission. All patients underwent integrated FDG PET-CT scan. Serum tumor markers were obtained within 3 months of PET-CT. All enrolled cases showed increase in a tumor marker over the reference value on at least two serial measurements or abnormal CT scan before PET-CT was performed. Results were compared with histopathological findings or clinical follow-up. Following exclusion of 57 patients with missing data or lost to follow-up, 155 patients (87 men, mean age: 61 years) remained for final analysis. Serum CEA and CA 19-9 had a sensitivity of 74 and 35% and specificity of 86 and 83% for the detection recurrent CRC, respectively. The sensitivities of CT and FDG PET-CT were 79 and 92% and specificities were 45 and 100%, respectively. At an adaptive threshold of 42%, the median SUVmax, SUVmean, MTV and TLG of these lesions were 8.8, 5.2, 11.3 cm[Formula: see text] and 55.4, respectively. All FDG PET-CT quantitative parameters correlated positively with serum CEA levels, and the correlation coefficients were 0.45, 0.44 and 0.49 for SUVmax, MTV and TLG [Formula: see text]. PET-CT scan, CEA and CA-19-9 results were correlated. However, both tumor markers had poor sensitivity to detect metastatic disease. PET-CT is more accurate than CT in detecting recurrent CRC in this study. Majority of the recurrences were in the liver and the sensitivity is affected by tumor histology. The correlation between semiquantitative FDG PET parameters and serum tumor marker levels is moderate.

Objective To analyze the effect of combined detection of serum tumor markers, Ki-67 and P-glycoprotein (PGP) in lymph node metastasis and postoperative recurrence of colorectal cancer patients. Methods The clinical data of 517 colorectal cancer patients who had underwent surgical treatment were retrospectively analyzed. Among them, lymph node metastasis was found in 165 cases (lymph metastasis group), and 352 cases did not have lymph node metastasis (non lymphoid metastasis); postoperative recurrence was found in 224 cases (postoperative recurrence group), and 293 cases did have postoperative recurrence (non postoperative recurrence group). The serum tumor markers levels of cancer antigen 19-9 (CA19-9), carcinoembryonic antigen (CEA), cancer antigen 125 (CA125) and the expressions of Ki-67, PGP were compared. The correlation between the serum tumor markers levels and the expressions of Ki-67, PGP was analyzed. Results The serum levels of CEA, CA19-9 and CA125 and the positive expression rates of Ki-67 and PGP in lymph metastasis group were significantly higher than those in non lymph metastasis group: (21.39 ± 3.15) μg/L vs. (10.12 ± 2.48) μg/L, (68.48 ± 5.82) U/L vs. (35.26 ± 3.51) U/L, (82.16 ± 7.53) U/L vs. (32.46 ± 6.24) U/L, 69.70% (115/165) vs. 13.64% (48/352) and 72.73% (120/165) vs. 14.77% (52/352), and there were statistical differences (P<0.01). The serum levels of CEA, CA19-9 and CA125 and the positive expression rates of Ki-67 and PGP in postoperative recurrence group were significantly higher than those in non postoperative recurrence group: (18.26 ± 2.34) μg/L vs. (9.18 ± 1.26) μg/L, (47.52 ± 4.85) U/L vs. (21.43 ± 2.18) U/L, (59.16 ± 4.25) U/L vs. (33.17 ± 3.46) U/L, 60.27% (135/224) vs. 9.56% (28/293) and 6.70% (15/224) vs. 7.51% (22/293), and there were statistical differences (P<0.01). The correlation analysis results showed that the positive expression rates of Ki-67 and PGP were positive correlated with the serum levels of CEA, CA19-9 and CA125 (P < 0.05). Conclusions The levels of serum tumor markers and the positive expression rates of PGP and Ki-67 in colorectal cancer patients with lymph metastasis and postoperative recurrence are high. The levels of tumor markers are closely related to the positive expression rates of Ki-67 and PGP, which indicates that the combined detection of these indexes has a good effect on evaluating lymph metastasis and postoperative recurrence of colorectal cancer patients. Key words: Colorectal neoplasms; Neoplasm metastasis; Tumor markers, biological; P-glycoprotein; Ki-67

The aetiology and pathogenesis of interstitial lung disease (ILD) and ILD combined with lung cancer (ILD-CA) are unclear. We aim to investigate serum tumour marker (STM) levels and to explore their predictive and diagnostic value of cancer in ILD. Fifty-eight patients with ILD-CA, 632 with ILD only and 628 with acute respiratory illness were studied. Serum levels of carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9), CA125 and neuron-specific enolase (NSE) were measured. All STM levels were elevated in ILD-CA compared with ILD group (P < 0.01). CEA and CA125 levels were significantly higher in ILD than in controls (P < 0.01). After adjustment for gender, age and smoking, ILD-CA risk in the CEA and CA125 fourth quartiles was increased compared with the first quartiles (CEA: odds ratio (OR) = 8.7, 95% confidence interval (CI) = 2.0-37.6; CA125: OR = 9.8, 95% CI = 2.3-42.7). Receiver operating characteristic (ROC) curve analysis in patients with ILD-CA showed a cut-off points of 3.99 ng/mL for CEA and 35.00 U/mL for CA125 with sensitivities of 74.6% and 71.9%, specificities 70.4% and 66.1%, and the areas under the curve 0.76 (95% CI = 0.69-0.82) and 0.75 (95% CI = 0.69-0.81), respectively. Serum CEA and CA125 levels are often elevated in ILD patients. The risk of cancer in ILD is increased with an elevation of serum CEA and CA125 levels. Serum CEA and CA125 levels may be a marker of cancer in ILD patients.

BackgroundHelicobacter pylori (H. pylori) is a carcinogenic bacterium, it is the greatest risk factor for gastric cancer (GC), according to these evidences, there may be a certain association between chronic H. pylori infections and serum levels of tumor markers. This study was conducted to determine serum levels of some tumor markers, namely carcinoembryonic antigen (CEA), cancer antigen 19-9 (CA19-9) and cancer antigen 72-4 (CA72-4) in patients with chronic H. pylori infections and evaluate the association between serum tumor marker levels and chronic patients with H. pylori infections in Ibb Governorate, Yemen.Subjects and methodsThis study involved 200 patients who had been diagnosed with H. pylori infections using a serum immunochromatography antibody test. Stool and blood samples were collected from all patients to confirm the presence of H. pylori through detection of serum H. pylori IgG antibody and stool antigen test (SAT). Additionally, serum samples were analyzed to measurement the level of certain tumor markers CEA, CA19-9 and CA72-4. These tests were conducted at various Hospitals, Gastroenterology and Hepatology clinics in Ibb governorate, Yemen from October 2019 to November 2020.ResultsThe findings of current study showed that the prevalence of H. pylori infections by rapid anti H. pylori test were 200 (100%), 157 (78.5%) by serum H. pylori IgG antibody and 108 (54%) by SAT. In addition, the results showed that 42 (21%) of the patients had abnormal level of CEA, 30 (15%) had abnormal level of CA19-9 and 31 (15.5%) had abnormal level of CA72-4. Most importantly, the results indicated that the serum tumor marker levels CEA, CA19-9 and CA72-4 were correlated with the levels of serum H. pylori IgG antibody as well as positive results from the SAT (P < 0.05). Furthermore, the results indicated that serum tumor marker levels were associated with different infection status. Finally, the results indicated that the serum levels of tumor markers were associated with older ages, symptomatic patients and long duration of H. pylori infections (P < 0.05).ConclusionThe findings of this study indicated that there is a significant association between chronic H. pylori infections and the serum levels of tumor markers (CEA, CA19-9 and CA72-4). This suggests that the patients with active chronic H. pylori infection may have an increased risk of developing GC. Therefore, monitoring and early detection of H. pylori infection and tumor markers levels in these patients may be crucial for identifying individuals at higher risk and implementing appropriate interventions.

Objective This study aimed to investigate the effect of radiotherapy on serum immune-associated cells and tumor markers in patients with esophageal cancer. Methods A total of 87 patients with esophageal cancer admitted to our hospital between October 2016 and July 2020 were selected as the observation group, and all patients received radiotherapy. A total of 87 healthy volunteers who underwent physical examination at our hospital during the same period were selected as the control group in order to compare the changes in serum immune-associated cells and tumor markers between the two groups. Results The levels of carcinoembryonic antigen (CEA), cancer antigen (CA) 125, CA72-4, C-terminus of cytokeratin (CYFRA) 21-1, and squamous cell carcinoma (SCC) antigen in the observation group before radiotherapy were higher than those in the control group, and the differences were significant (P &lt; 0.05). The levels of CEA, CA125, CA72-4, CYFRA21-1, and SCC antigen in the research group after radiotherapy were significantly lower than those before radiotherapy, but were still significantly higher than those in the control group (P &lt; 0.05). The levels of CD3+, CD4+, CD4+/CD8+, and natural killer cells in the research group before and after radiotherapy were significantly lower, while the levels of Treg and CD8+ cells were significantly higher than those in the control group (P &lt; 0.05). The levels of CD3+, CD4+, and CD4+/CD8+ cells in the observation group after radiotherapy were lower, while the levels of CD8+ cells were significantly higher than those before radiotherapy (P &lt; 0.05). Conclusion Radiotherapy can effectively reduce the level of serum tumor markers in patients with esophageal cancer; these antigens and cells can be used as tumor markers of esophageal cancer in order to determine its prognosis. However, radiotherapy has adverse effects on the immune function of the body. The reasons behind this need to be further studied and analyzed.

To investigate the clinical value of serum concentration of carcinoembryonic antigen (CEA), carbohydrate antigen 24-2 (CA24-2), and carbohydrate antigen 19-9 (CA19-9) in the detection of colorectal cancer (CRC). The serum levels of tumor markers and KRAS/NRAS/PIK3CA/BRAF gene mutations were detected in patients with colorectal cancer. Clinical medical records in colorectal cancer patients were collected. A total of 2,281 patients were recruited in the study, included 1,578 colorectal cancer patients and 703 controls. CEA, CA24-2, and CA19-9 concentrations were significantly higher in the colorectal cancer group than in the control group. The sensitivity of these tumor markers sorted in descending order was CEA>CA19-9>CA24-2. The best specificity was CA24-2, followed by CA19-9 and CEA, with all were more than 92%. The combination of CEA, CA19-9, and CA24-2 ranked the best sensitivity and specificity for colorectal cancer diagnosis. The prediction equation excluding the risk of colorectal cancer was. Probability (normal) = Exp (-5.47 - 0.28*CEA - 0.11*CA242 + 0.001*CA199)/(1+ Exp (-5.47 - 0.28*CEA - 0.11*CA242 + 0.001*CA199)). Besides, there were no significant differences in age, gender, histology type, differentiation, depth of invasion, and TNM stage in KRAS/ NRAS, BRAF, and PIK3CA mutations compared with wild type. Serum CEA, CA24-2, and CA19-9 are valuable indicators for predicting the risk of colorectal cancer.

The CRC-VTE trial conducted in China revealed a significant occurrence of venous thromboembolism (VTE) in patients following colorectal cancer (CRC) surgery, raising concerns about implementing thromboprophylaxis measures. The present study aimed to identify and analyze inappropriate aspects of current thromboprophylaxis practices. This study performed an analysis of the CRC-VTE trial, a prospective multicenter study that enrolled 1836 patients who underwent CRC surgery. The primary objective was to identify independent risk factors for VTE after CRC surgery using multivariate logistic regression analysis. Furthermore, among the cases in which VTE occurred, the appropriateness of thromboprophylaxis was assessed based on several factors, including pharmacologic prophylaxis, time to initiate prophylaxis, drug selection, drug dosage, and duration of pharmacologic prophylaxis. Based on the analysis of the current state of thromboprophylaxis and relevant clinical guidelines, a modified Delphi method was used to develop a clinical pathway for VTE prophylaxis after CRC surgery. In this analysis of 1836 patients, 205 (11.2%) were diagnosed with VTE during follow-up. The multifactorial analysis identified several independent risk factors for VTE, including age (≥70 years), female sex, varicose veins in the lower extremities, intraoperative blood transfusion, and the duration of immobilization exceeding 24 h. None of the patients diagnosed with VTE in the CRC trial received adequate thromboprophylaxis. The main reasons for this inappropriate practice were the omission of thromboprophylaxis, delayed initiation, and insufficient duration of thromboprophylaxis. We developed a specialized clinical pathway for thromboprophylaxis after CRC surgery to address these issues. This study offers a comprehensive nationwide evaluation of existing thromboprophylaxis practices in patients after CRC surgery in China. A specialized clinical pathway was developed to address the identified gaps and improve the quality of care. This clinical pathway incorporates explicit, tailored, detailed recommendations for thromboprophylaxis after CRC surgery.

Morbid obesity (Basic Mass Index ≥ 40 kg/m(2)) leads to increased long-term mortality after colorectal cancer (CRC) surgery. Little is known about its effects on peri-operative CRC surgery outcomes. 85,300 discharges for CRC surgery were identified using the redesigned 2012 National Inpatient Sample. Outcomes of interest were mortality, healthcare charges, and surgical outcomes in morbidly obese patients which were compared to those in nonobese patients. There were 4385 (5.14%) morbidly obese patients who underwent CRC surgery during the study period. Morbid obesity was associated with younger age, females, and African Americans in our study (p < 0.05). Morbidly obese patients had higher prevalence of CRC peri-operative co-morbidities, surgical complications, and conversions from laparoscopic to open surgery. On multivariate analysis, morbid obesity led to an increased CRC surgery peri-operative mortality (OR 1.85, 95 % CI 1.15, 2.97). Mortality remained significant even after adjusting for surgical complications (OR 1.79, 95 % CI 1.12, 2.88). Morbidly obese patients undergoing CRC also had a prolonged length of hospitalization (1.22 day, 95 % CI 0.67, 1.78), a $15,582 increase in total hospital charges (95 % CI 8419, 22,745), and increased disposition to short-term rehabilitation facilities (OR 2.25, 95 % CI 1.79, 2.84). Analysis of national level data demonstrates that morbidly obese patients have an increased CRC surgery peri-operative mortality with higher prevalence of co-morbidities, surgical complications, and more health care resource utilization. Future research efforts should concentrate on ameliorating these outcomes in morbidly obese patients.

PurposeThe purpose of the current study was to evaluate the impact of colorectal cancer (CRC) surgery on type 2 diabetes mellitus (T2DM) and to analyze the change in T2DM on overall survival after CRC surgery.MethodsPatients who underwent CRC surgery were retrospectively enrolled from January 2013 to December 2019. The status of T2DM pre- and 1-year after CRC surgery was recorded, and predictive factors for T2DM remission and overall survival were analyzed.ResultsA total of 296 patients were included in this study. Thirty-eight patients experienced remission of T2DM 1 year after CRC surgery, and the remission rate was 12.8%. Weight loss was significantly higher in the T2DM remission group (p = 0.038), and the T2DM duration was significantly shorter in the T2DM remission group (p = 0.015). In the multivariate logistic regression analysis, higher weight loss (p = 0.046, odds ratio = 1.060, 95% CI = 1.001–1.122) and shorter T2DM duration (p = 0.019, odds ratio = 1007, 95% CI = 1.001–1.014) were predictive factors for remission of T2DM. Furthermore, in multivariate Cox regression analysis, lower TNM stage (p = 0.000, odds ratio = 2.147, 95% CI = 1.474–3.128) and T2DM remission (p = 0.033, odds ratio = 2.999, 95% CI = 1.091–8.243) were the predictive factors for better overall survival.ConclusionPatients with concurrent CRC and T2DM had a 12.8% remission 1 year after CRC surgery. Higher weight loss and shorter T2DM duration contributed to T2DM remission, and patients with T2DM remission could improve in terms of their overall survival.

Intensive follow-up after surgery for colorectal cancer is common practice but is based on limited evidence. To assess the effect of scheduled blood measurement of carcinoembryonic antigen (CEA) and computed tomography (CT) as follow-up to detect recurrent colorectal cancer treatable with curative intent. Randomized clinical trial in 39 National Health Service hospitals in the United Kingdom; 1202 eligible participants were recruited between January 2003 and August 2009 who had undergone curative surgery for primary colorectal cancer, including adjuvant treatment if indicated, with no evidence of residual disease on investigation. Participants were randomly assigned to 1 of 4 groups: CEA only (n = 300), CT only (n = 299), CEA+CT (n = 302), or minimum follow-up (n = 301). Blood CEA was measured every 3 months for 2 years, then every 6 months for 3 years; CT scans of the chest, abdomen, and pelvis were performed every 6 months for 2 years, then annually for 3 years; and the minimum follow-up group received follow-up if symptoms occurred. The primary outcome was surgical treatment of recurrence with curative intent; secondary outcomes were mortality (total and colorectal cancer), time to detection of recurrence, and survival after treatment of recurrence with curative intent. After a mean 4.4 (SD, 0.8) years of observation, cancer recurrence was detected in 199 participants (16.6%; 95% CI, 14.5%-18.7%) overall; 71 of 1202 participants (5.9%; 95% CI, 4.6%-7.2%) were treated for recurrence with curative intent, with little difference according to Dukes staging (stage A, 5.1% [13/254]; stage B, 6.1% [34/553]; stage C, 6.2% [22/354]). Surgical treatment of recurrence with curative intent was 2.3% (7/301) in the minimum follow-up group, 6.7% (20/300) in the CEA group, 8% (24/299) in the CT group, and 6.6% (20/302) in the CEA+CT group. Compared with minimum follow-up, the absolute difference in the percentage of patients treated with curative intent in the CEA group was 4.4% (95% CI, 1.0%-7.9%; adjusted odds ratio [OR], 3.00; 95% CI, 1.23-7.33), in the CT group was 5.7% (95% CI, 2.2%-9.5%; adjusted OR, 3.63; 95% CI, 1.51-8.69), and in the CEA+CT group was 4.3% (95% CI, 1.0%-7.9%; adjusted OR, 3.10; 95% CI, 1.10-8.71). The number of deaths was not significantly different in the combined intensive monitoring groups (CEA, CT, and CEA+CT; 18.2% [164/901]) vs the minimum follow-up group (15.9% [48/301]; difference, 2.3%; 95% CI, -2.6% to 7.1%). Among patients who had undergone curative surgery for primary colorectal cancer, intensive imaging or CEA screening each provided an increased rate of surgical treatment of recurrence with curative intent compared with minimal follow-up; there was no advantage in combining CEA and CT. If there is a survival advantage to any strategy, it is likely to be small. isrctn.org Identifier: 41458548.

Aim: to evaluate the outcomes of surgical treatment of patients with multiple primary cancer of the colon and prostate.Materials and methods. An observational retrospective study was conducted at the Clinic of Coloproctology and Minimally Invasive Surgery (I.M. Sechenov First Moscow State Medical University). A total of 3,640 protocols of the preoperative multidisciplinary team were studied from July 2018 to April 2024. The inclusion criterion was the diagnosis of multiple colorectal and prostate cancer. The medical documentation was collected in the database and analyzed.Results. The study included 39 patients: 24 patients with a metachronous variant of multiple primary cancer and 15 patients with a synchronous variant of the disease, which amounted to 1.1 % of all patients who underwent a preoperative consultation during the specified period. There were no significant differences in age, localization of tumors in the colon, methods of their treatment, access in surgical treatment of colorectal cancer, frequency of conversions and postoperative complications (p &gt; 0.05). Prostate cancer was verified first in the group with the metachronous variant of multiple primary cancer significantly more often than in the group with the synchronous variant (95.8 % vs. 40.0 %, respectively; p &lt; 0.001), and was also significantly more often treated surgically (75.0 % vs. 33.3 %; p = 0.018). Radical prostatectomy was performed via laparotomy significantly less frequently in the group with the synchronous variant than in the group with the metachronous cancer (0 % vs. 58.8 %; p = 0.046). No significant differences were found when comparing overall and recurrence-free survival in groups with metachronous and synchronous variants of multiple primary cancer.Conclusions. A clinician should be alert to multiple primary colorectal and prostate cancer. The first stage of therapy for the synchronous variant should be surgical treatment of colorectal cancer. The history of surgical treatment of one of the tumors is not a contraindication for the use of minimally invasive techniques, however, the choice of surgical approach should be individualized. The presence of prostate cancer may be another factor in favor of performing lateral lymph node dissection in patients with synchronous rectal cancer.

Colorectal cancer is one of the malignant tumors with a high incidence and mortality rate globally, and the occurrence of liver metastasis significantly affects patient survival prognosis. In recent years, the application of immune checkpoint inhibitors (ICIs) in cancer treatment has made important progress, especially showing good therapeutic effects in patients with high microsatellite instability or mismatch repair deficiency. However, for the majority of patients with microsatellite stable (MSS) or proficient mismatch repair (pMMR) colorectal cancer, the efficacy of ICIs is limited, prompting researchers to explore combination therapy strategies to improve efficacy. Targeted drugs such as tyrosine kinase inhibitors (TKIs) and radiotherapy are believed to work synergistically with ICIs by modifying the tumor microenvironment and enhancing antigen presentation. To investigate the efficacy and safety of the combination therapy of radiotherapy, ICIs, and TKIs in patients with MSS or pMMR colorectal cancer liver metastasis (CCLM), in order to provide new clinical treatment references. A retrospective analysis was conducted on the clinical data of 43 MSS or pMMR CCLM patients treated at our hospital from September 2021 to July 2024. Based on the treatment interventions received, the patients were divided into a control group (n = 21, receiving ICIs and TKIs combination therapy) and an observation group (n = 22, receiving radiotherapy, ICIs, and TKIs triple therapy). The therapeutic effects, serum tumor markers (carcinoembryonic antigen and carbohydrate antigen 199), survival status, and adverse reactions were compared between the two groups. The disease control rate in the observation group (63.64%) was significantly higher than that of the control group (23.81%) (P < 0.05). Both groups showed a decrease in carcinoembryonic antigen and carbohydrate antigen 199 levels post-treatment, with the observation group demonstrating a more significant change (P < 0.05). The median progression-free survival and median overall survival in the control group were 5.1 months and 7.6 months, respectively, while the observation group had a median progression-free survival and overall survival of 4.3 months and 6.9 months, respectively. The control group had longer survival times than the observation group, but the differences were not statistically significant (P > 0.05). The incidence of adverse reactions, including nausea and vomiting, gastrointestinal reactions, skin reactions, bone marrow suppression, liver and kidney function impairment, neurotoxicity, leukopenia, neutropenia, and thrombocytopenia, showed no significant differences between the two groups (P > 0.05). Compared to the ICIs and TKIs combination therapy, the radiotherapy, ICIs, and TKIs triple therapy can further improve the disease control rate and serum tumor marker levels in MSS or pMMR CCLM patients without increasing the risk of related adverse reactions, making it a treatment regimen worthy of further validation.

ObjectiveTo explore the influence of trastuzumab (TZ) combined with docetaxel (DTX) on serum tumor markers (TMs) in the treatment of human epidermal growth factor receptor 2-positive (HER-2+) breast cancer (BC) and to analyze the factors influencing therapeutic efficacy.MethodsNinety-six patients with HER-2+ BC treated in the First Affiliated Hospital of Anhui University Of Science and Technology from January 2019 to December 2020 were selected. According to different treatment plans, the patients were divided into two arms with 48 cases each. The control group (CG) was treated with DTX, and the research group (RG) was given TZ combined with DTX (TZ+DTX). The two arms were compared regarding the following aspects: curative effects, adverse reaction, alterations of TMs and inflammatory factors (IFs), and quality of life. Logistic regression analysis was performed to analyze the factors affecting the efficacy of patients.ResultsAfter treatment, the TMs carcinoembryonic antigen (CEA), carbohydrate antigen (CA)125 and CA15-3 were significantly lower in RG compared with CG. The levels of IFs C-reactive protein (CRP) and tumor necrosis factor-α (TNF-α) were also lower in CG. The overall response rate and the Karnofsky performance status (KPS) score were significantly higher in RG. No evident difference was observed in the total incidence of adverse reactions between the two arms. The high expression of CEA, CA125 and CA15-3 as well as DTX monotherapy increased the risk of adverse prognosis.ConclusionTZ+DTX can effectively improve the clinical efficacy of HER-2+ BC patients and reduce their levels of serum TMs and IFs.