Cancer Research Articles (Page 1)

The evolving treatment landscape of muscle-invasive bladder cancer (MIBC) increasingly warrants novel trial design to evaluate perioperative strategies aimed at bladder preservation. To establish standardized outcome measures for evaluating organ preservation strategies in MIBC, the International Bladder Cancer Group (IBCG) and the Global Society of Rare Genitourinary Tumors (GSRGT) assembled an international, multidisciplinary consensus panel. The IBCG and GSRGT gathered global bladder cancer experts and patient advocates to establish a framework for risk-adapted bladder-sparing treatment approaches for MIBC. Working groups reviewed the literature and developed draft recommendations, which were discussed at a live meeting in December 2024 in Milan. This was followed by voting by the members using a modified Delphi process. Recommendations achieving ≥75% agreement during the meeting were further refined and presented. Clinical complete response (cCR) definition should encompass the absence of high-grade malignancy on pathology and malignant cells on urine cytology and no evidence of local or metastatic disease on cross-sectional imaging. Although cCR remains immature as a primary or coprimary end point in registrational trials, it could serve as a suitable end point in early-phase studies and risk-adapted investigations. Event-free survival (EFS) remains the preferred primary end point as it could reliably capture the durability of clinically meaningful benefit after omittance of surgical consolidation or chemoradiation. Given the composite nature of EFS, events should be prespecified, evaluated in an intention-to-treat approach, and meticulously collected. Continuous assessment of individual patient preferences should begin at the outset of perioperative therapy discussions, with informed decision making prioritized throughout. The consensus definition of cCR and the framework presented in this study can serve as a foundation for thorough testing of risk-adapted bladder-sparing treatment paradigms for MIBC.

Emerging evidence underscores the pivotal yet context-dependent role of butyrate metabolism in oncogenic progression; however, the mechanistic landscape of its associated genetic determinants in prostate carcinogenesis remains poorly characterized. This gap presents a critical opportunity to delineate novel metabolic checkpoints that may offer therapeutic vulnerabilities for advanced prostate malignancies.Analyzing prostate cancer (PC) patients from TCGA and GEO databases, we identified 320 BMGs and stratified tumors into two butyrate metabolism-associated clusters. Machine learning and single-cell transcriptome analysis are used for further study. Luciferase reporter assay, qRT-PCR, FISH, and functional assays are applied to investigate the role of FOS.BMC1 correlated with aggressive phenotypes and stromal-rich tumor microenvironments, while BMC2 was linked to cell cycle regulation and DNA repair. A machine learning-derived RSF + GBM prognostic model demonstrated robust predictive accuracy for biochemical recurrence (training C-index: 0.85). BM scores are further associated with tumor mutation burden and differential drug sensitivities. FOS is overexpressed in PC, promotes proliferation and migration via transcriptional suppression of tumor-suppressive miR-27b. Clinical cohorts confirmed FOS's correlation with advanced T stages and recurrence risk.These findings establish BM-based stratification as a prognostic tool and implicate the FOS-miR-27b axis as a therapeutic target, bridging metabolic heterogeneity with molecular mechanisms in PC progression. Our research offers a critical opportunity to delineate novel metabolic checkpoints that may offer therapeutic vulnerabilities for advanced prostate malignancies.

Colorectal cancer is the third leading cause of cancer-related deaths worldwide. Its incidence has been rising in Africa due to urbanization and changing lifestyles. In Ethiopia, the lack of early diagnosis and specialized care places an additional burden on patients. Ostomy surgery, commonly used to manage advanced cases of colorectal cancer, significantly affects patients' quality of life. Despite the well-documented challenges, there is a limited number of studies investigating the experiences of Ethiopian colorectal cancer patients and their caregivers. This study aims to explore the impact of living with an ostomy on both patients and their caregivers. The qualitative descriptive study with a phenomenological approach was conducted from February to May 2024 at St. Paulo Comprehensive Specialized Hospital, Ethiopia. Purposive sampling was used to recruit adult colorectal cancer patients with ostomies and their caregivers. In-depth individual and shared interviews were conducted using a semi-structured guide. Data quality assurance was maintained and analyzed using thematic analysis guided by family systems theory. A total of 28 participants (14 patients and 14 caregivers) were included in the study. Thematic analysis identified seven themes across three domains. From the patients' perspective, three themes emerged: psychological burden (altered self-image and confidence and sense of insecurity), daily challenges (routine care obstacles and lifestyle restrictions), and social detachment (self-stigmatization, self-imposed isolation, and identity loss). Caregivers highlighted two themes: role redefinition (practical challenges and loss of personal freedom) and caregiving burden (work-life balance and financial strain). Additionally, shared interviews with patients and caregivers revealed two further themes: challenges in communication (avoidance of difficult conversations and intimacy dynamics) and boundary negotiation (decision-making tension and evolving responsibilities). The current study described the experience of colorectal cancer patients with ostomies and their caregivers within a family systems theory framework while revealing cultural factors such as social detachment, identity loss, and self-imposed isolation. The findings call for culturally sensitive interventions that address both emotional and social challenges. It emphasizes the need for support systems that encourage social reengagement and open communication, with a focus on holistic care that considers cultural context.

The Experimental Cancer Medicine Centre (ECMC) Network supports UK-wide access to experimental cancer therapies, many of which require specific genomic alterations. This study aimed to develop expert consensus on essential genes for a pan-cancer sequencing panel, involving subject matter experts (SMEs) from the ECMC Network and the pharmaceutical industry. A pilot with 8 SMEs graded 526 genes, refining the list to 210. A three-round Delphi process was then used, with SMEs iteratively evaluating each gene. In the final round, SMEs also assessed the inclusion of tumour mutational burden (TMB), microsatellite instability (MSI), and mutation types (structural variations, copy number variations, and/or fusions). Consensus was reached on a final panel of 99 genes applicable across multiple cancers. High agreement was also achieved for including TMB, MSI, and screening for structural variations, copy number variants, and fusions. The panel is intended for both adult and paediatric tumour types. This consensus-based gene panel offers a standardised approach to pan-cancer genomic screening. It supports harmonised diagnostics and could improve patient access to personalised therapies and research trials across clinical and NHS settings.

A novel integrative biomarker, the systemic immune-inflammatory index (SII), has been understudied in cancer research. This study aimed to examine potential associations between body mass index (BMI) and SII in cancer patients. It included cancer patients aged 20 to 79 from the National Health and Nutrition Examination Survey (NHANES) conducted between 2013 and 2018. A cross-sectional analysis comparing SII and BMI was performed using EmpowerStats software (version 3.4.3) and R packages. We utilized multivariate regression analysis to examine the association between SII and BMI in cancer patients. To further explore the relationship between the 2, we employed threshold effect analysis, stratified analysis, and smoothed curve fitting. The study included 1067 cancer patients, with a mean SII value of 553.32 ± 390.44. Our multivariate regression analysis revealed a positive association exists between BMI and SII in the fully adjusted model, with this relationship observed across all 3 groups. The threshold value between log-transformed SII (lgSII) and BMI, as identified by the segmented linear regression model, was 3.04 (×103 cells/μL). However, no inflection point was observed in female patients following stratification by gender. Our findings suggest that SII may reflect the systemic inflammatory status associated with obesity. However, its predictive value requires further validation in prospective studies.

This study was conducted to examine the relationship between cancer patients' spiritual needs and their quality of life and depression levels. This cross-sectional, exploratory study was conducted between March 2023 and November 2024. The study population consisted of cancer patients hospitalized in medical oncology departments at a university hospital in eastern Turkey. The sample consisted of 250 patients, determined by power analysis. To collect data, the "Demographic Information Form," "Spiritual Needs Assessment Scale," "EORTC QLQ-C30 Version 3.0 Quality of Life Scale," and "Beck Depression Scale" were used to evaluate the patients' sociodemographic characteristics and disease process. There was a weak, negative, statistically significant relationship between patients' spiritual needs and the subdimensions of the quality of life scale, specifically the general perceived health status (r = -0.297, p < 0.001), physical (r = -0.446, p < 0.001), role (r = -0.423, p < 0.001), emotional (r = -0.472, p < 0.001), cognitive (r = -0.458, p < 0.001) and social (r = -0.443, p < 0.001) functions, and finally, a weak positive correlation was found between the symptoms experienced (r = 0.376, p < 0.001) and depression levels. Additionally, a weak positive correlation between spiritual needs and depression level (r = 0.374, p < 0.001) was identified. Functional areas, depression, education level, diagnosis duration, and symptoms were identified as variables predicting spiritual needs. In conclusion, it was determined that as the spiritual needs of cancer patients increased, their quality of life decreased and the severity of depression increased.

Accurate capture and analysis of circulating tumor cells (CTCs) from cancer patients' blood are crucial for early diagnosis, prognosis, and personalized therapy of cancer. However, it is a significant challenge to develop an efficient and cost-effective method for the isolation and analysis of CTCs from a complex peripheral blood. Herein, we developed a novel microfluidic platform integrated with SU-8 nanodendritic pyramidal microcone array deposition of gold film (SNPMA/Au) substrate for the multistage capture of CTCs and in situ single-cell heterogeneity analysis using the surface-enhanced Raman scattering (SERS) technology. The staggered pyramid structure greatly increased the collision probability between the substrate and CTCs, while nanodendritic structure with aptamer modification on the surface of SNPMA/Au provided conditions for cancer cell attachment, which thereby realized the efficient capture (90.6% ± 4.5%). The pre-enrichment chamber of the chip was designed to increase the concentration of cancer cells, simultaneously reducing the movement rate of CTCs into the capture chamber. Finally, the SERS-microfluidic platform is capable of the efficient capture of CTCs from whole blood, and biomarkers expressed on cancer cells can be readily identified through SERS mapping technology. Therefore, the cellular heterogeneity can be highlighted through variations of biomarker distribution and expression levels. With the successful capture and detection of CTCs in a clinical sample by this platform, it is anticipated that this technology could serve a crucial role in the rapid and sensitive diagnosis of cancer diseases in clinical applications.

An independent association between insulin resistance and cancer has been consistently reported in humans. Patients with cancer display insulin resistance or its clinical manifestations, and this metabolic adaptation precedes the clinical diagnosis of cancer. Insulin resistance in cancer patients is associated with a metabolic switch from oxidative metabolism toward glycolysis that spares oxygen to be used in anabolic processes and facilitates the fast production of energy and intermediate metabolites required for the rapid proliferation of cancer cells. In malignant cells, glucose consumption via glycolysis occurs under normoxic conditions (aerobic glycolysis). Pathogenic mechanisms underlying insulin resistance in cancer patients include hypoxia-inducible factor-1 upregulation and overproduction of cytokines, such as interferon, interleukin-6, interleukin-18, and interleukin-1β. Deficit of 2-oxoglutarate (α-ketoglutarate) has been detected in cancer cells and may facilitate hypoxia-inducible factor-1 assembly and activity. Overproduction of cytokines in cancer patients follows activation of the immune system by abnormal nucleic acid variants. Anomalous DNA or RNA structures are recognized by immune sensors and stimulate signaling pathways that ultimately increase cytokine production. Likewise, interferon overproduction occurs in congenital disorders that feature ineffectively repaired DNA lesions, such as Werner syndrome, Bloom syndrome, mutations in DNA polymerase-δ1, and ataxia telangiectasia. These diseases cause simultaneous insulin resistance and a high tendency to develop cancer, highlighting the relationship between the two processes. Defectively repaired DNA injury endangers genomic integrity, predisposing to cancer, and activates the immune system to increase interferon production and subsequent insulin resistance. Hypoxia-inducible factor-1 and cytokines induce insulin resistance by suppressing peroxisome proliferator-activated-γ in the subcutaneous adipose tissue.

Despite being among the most common cancer treatment-related side effects, taste disorders have received limited study, and their management remains challenging. Recent data have associated dysgeusia with decreased quality of life and increased mortality. We discuss here the state of the science on this topic and address clinical concerns and understudied therapeutics, with the aim of stressing the importance of this side effect and the need for effective treatment. We selected extant articles covering cancer therapy-associated dysgeusia in English language peer-reviewed literature from PubMed, Medline, Cochrane Library, and Scopus databases. We identified 368 articles, of which 92 were reviewed in detail. The relevant publications have described heterogeneous populations and a multitude of clinical characteristics. The mechanisms of altered taste perception in cancer populations have not been completely elucidated, which in turn has impaired the development of potential interventions, including prevention and management. Dysgeusia in cancer patients may be more relevant to treatment success and quality of life than previously accepted. Unfortunately, this topic has not been adequately addressed and requires further study.

Background The advent of angiogenesis inhibitors expand therapeutic options for tumors but pose challenges due to bleeding risks, especially in patients requiring anticoagulation therapy for cancer-associated hypercoagulability. Objectives This study aimed to evaluate whether combining anticoagulants with angiogenesis inhibitors increases bleeding risk in cancer patients. Methods A network meta-analysis was conducted based on PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials to compare bleeding risks with angiogenesis inhibitors alone versus their combination with anticoagulants. Furthermore, a real-world cohort of 645 patients receiving antiangiogenic therapies between January 2010 and June 2024 was performed. Patients were separated into two groups according to whether they were receiving concomitant anticoagulants. The primary outcome was all-grade bleeding events. Results Of 2644 patients from 6 studies included in network meta-analysis, all-grade bleeding events were found in 614 (23.2%) patients. The addition of anticoagulation to either high-dose bevacizumab (10 or 15 mg/kg) (OR 4.95, 95% CI: 2.68-9.42) or antiangiogenic tyrosine kinase inhibitors (OR 2.2, 95% CI: 1.08-4.44) significantly increased bleeding risk compared to antiangiogenic monotherapy, except for low-dose bevacizumab (5 or 7.5 mg/kg). In the cohort study, 163 patients matched in each group after propensity score matching weighting. Over a median follow-up duration of 56 days, there were 28 (17.2%) all-grade bleeding events during concurrent treatment and 16 (9.8%) all-grade bleeding events reported during antiangiogenic monotherapy. Conclusions Adding anticoagulation to high-dose bevacizumab or antiangiogenic TKIs might increase bleeding risk compared to monotherapy. Conversely, anticoagulants appeared to be safe in patients receiving low-dose bevacizumab.

Febrile neutropenia (FN) in cancer patients undergoing chemotherapy can result in life-threatening outcomes. Hence, an evaluation of associated risk factors can enable clinical surveillance as well as inform prophylactic measures. In this retrospective cohort study, we report a mortality prognostication model for chemotherapy-treated cancer patients upon a neutropenic episode. Clinical and diagnostic data of 137 febrile neutropenia patients (>18 years) was collected from a cancer hospital, with the primary endpoint of post-hospital admission mortality within 30 days. The data was integratively analyzed and machine learning techniques were applied to develop the predictive model which was then internally cross validated. Towards enabling personalized risk assessment, a nomogram was constructed and validated. Chemotherapy-treated cancer patients undergoing a neutropenic episode exhibit an overall mortality rate of 17.36%. Multivariate logistic analysis elucidates that shock, pneumonia, carboplatin, doxorubicin, antifungal and anti-viral prophylaxis, and hemoglobin correctly classify cases with an overall accuracy of 92% and discriminate mortality with a specificity of 76%. Antiviral (odds ratio (OR): 0.669, p = 0.689) and antifungal prophylaxis (OR: 0.619, p = 0.5) demonstrate a protective effect. The receiver operating characteristic (ROC) curve of the nomogram exhibits an area under the curve of 0.878 (95% CI 0.778 - 0.977), Hosmer-Lemeshow test p-value = 0.635, and a high net benefit in the clinical decision curve. The proposed model offers insights into the role of clinical predictors as well as treatment characteristics that can ameliorate mortality risk in cancer patients with FN. The study highlights bacteremia-related surveillance, along with thrombocytopenia, linked to carboplatin, for reducing individualized mortality risk along with improved monitoring and informed treatment strategies.

Metastasis is the primary cause of death in advanced/recurrent cancer patients. Cancer metastatic capability depends not only on cancer cells but also on the cancer microenvironment, particularly cancer-associated fibroblasts (CAFs), a highly heterogeneous population. Our prior work identified a POSTN-secreting CAFs subpopulation linked to gastric cancer (GC) invasion and poor survival. The Cancer Genome Atlas analysis in GC showed POSTN association with epithelial-mesenchymal transition and extracellular matrix degradation pathways. In vitro, GC exosomes induced adipose-derived mesenchymal stem cells (MSCs) into POSTN-expressing CAFs. Lentiviral POSTN overexpression in CAFs enhanced GC cell migration/invasion, while knockdown had the opposite effect. These results were validated in a nude mouse GC model. As POSTN is an integrin ligand, POSTN-positive CAFs (POSTN+ CAFs) activated integrin downstream AKT signaling. AKT inhibition significantly diminished the pro-migratory/invasive effect of POSTN-overexpressing CAFs. In summary, POSTN+ CAFs promote GC invasion via AKT pathway activation.

This study attempted to evaluate the incidence of incidentalomas based on computed tomography (CT) in colorectal cancer (CRC) patients. CRC patients who obtained plan or enhanced CT for the whole abdominal and pelvis were included at the First Affiliated Hospital of Chongqing Medical University, Chongqing, China. Incidentalomas, including uterine tumors, adrenal gland tumors, renal cancer, pancreatic tumors, prostatic tumors, ovarian tumors, upper-tract urothelial cancer, and gallbladder tumors, were assessed based on all radiology reports by radiologists and surgeons. Moreover, the clinical characteristics of all patients were collected. A total of 7053 CRC patients (mean age, 62.6 ± 12.3; 4139 male) were finally included, 255 (3.6%) patients had an incidentaloma. The proportions of uterine tumors, adrenal gland tumors, renal cancer, pancreatic tumors, and prostatic tumors were 1.3% (92/7053), 1.1% (77/7053), 0.7% (46/7053), 0.1% (15/7053), and 0.1% (10/7053), respectively. Ovarian tumors, upper-tract urothelial cancer, and gallbladder tumors all had an incidence of <0.1%. The prevalence of incidentalomas in CRC patients was 3.6% (255/7053). The most common incidentalomas was uterine tumor, followed by adrenal gland tumor, and renal cancer. These findings highlighted the importance of careful evaluation of abdominal and pelvic CT scans in CRC patients, as timely detection and management of incidentalomas might optimize treatment strategies and improve patient outcomes.

In human epidermal growth factor receptor 2 (HER2) positive early breast cancer (EBC) patients, with residual invasive disease after neoadjuvant chemotherapy (NACT) plus HER2-targeted therapy, the KATHERINE trial demonstrated a 50% reduction in risk of recurrence or death with adjuvant trastuzumab emtansine (T-DM1) versus trastuzumab. A retrospective bicentric cohort study was set to assess the real-world efficacy and safety of T-DM1 as adjuvant therapy in HER2-positve EBC patients treated at Institut Curie Hospitals. N = 102 patients consecutively treated from September 2019 to January 2021 were included. All patients had previously received neoadjuvant trastuzumab (plus pertuzumab in one patient) and chemotherapy, N = 95 (93%) with anthracyclines. Post-neoadjuvant residual cancer burden was RCB I, II and III in N = 28 (27%), 62 (61%) and 11 (11%) patients, respectively, while N = 70 (69%) had an estrogen receptor-positive disease. After a median follow-up of 44 months (range 4.5-54), N = 7 (7%) patients experienced distant tumor recurrence, including central nervous system (CNS) metastases in N = 5 patients, leading to death in N = 2 patients, while no local recurrence was reported. The 4-years disease-free survival (DFS) rate was 92.5% (95%CI=[87;98]), lymph node involvement at diagnosis (cN+) being the only factor associated with a higher risk of relapse (p = 0.025, no event in the node negative group in our population). Dose reductions of T-DM1 were required in N = 34 patients (33%) after a median of 5 cycles, mainly because of peripheral neuropathy (N = 14), increased alanine and/or aspartate aminotransferase level (N = 9), and thrombopenia (N = 6). Adverse event leading to drug discontinuation occurred in N = 23 patients (23%), after a median of 9 cycles, mostly peripheral neuropathy (N = 10) and thrombopenia (N = 9). Grade 3-4 toxicity affected N = 9 patients (9%), with no related death to T-DM1. With a low relapse rate and although more dose reductions and treatment discontinuation were observed in our cohort, our results are consistent with those of the KATHERINE trial. CNS as the most frequent site of relapse points to a potential role for drugs with higher activity against CNS metastases.

Spirulina platensis (S. platensis) is a natural microalgae extract that exerts significant cytotoxic effects against different serious cancerous diseases. Lung cancer is one of the most common and leading causes of death all over the world. The purpose is to investigate the anti-proliferative cytotoxic effects of S. Platensis against the adenocarcinomic human alveolar basal epithelial cells (A549 cell line). Also, molecular docking Analysis and pathway Map were investigated. The viability of the cells was determined via the MTT assay. Moreover the lipid peroxidation, total thiol, the protein concentration of Microtubule-associated tumor suppressor 1 (MTUS1), P16, Kirsten rat sarcoma viral oncogene homolog (K-ras), the epidermal growth factor receptor (EGFr), and the molecular parameters (short stature homeobox 2 (SHOX2), Breast cancer metastasis suppressor 1 (BRMS1), B-cell lymphoma 2 (BCL-2), and Bcl-2-associated X protein (BAX) were assessed. In order to define interaction sites and classes, the current study investigates in detail the interactions between the ligand S. platensis and the Interleukin enhancer-binding factor 3 Receptor (IL-F3) of lung cancer. Covalent bonds, H-bonds, and hydrophobic interactions were observed to form with critical residues on the active site. Covalent bonds are identified in seventeen of the complexes. A correlation was observed between binding affinity and molecular size, branching, polar surface area of up to 199 Å2, hydrophilicity, and topological diameter for various bonds. In an effort to enhance pharmaceutical quality control, we utilized in silico methodologies to forecast the ADMET (absorption, distribution, metabolism, excretion, and toxicity) of S. platensis. Results revealed a great anti-proliferative cytotoxic effect with a concentration gradient through decreasing the peroxidation content, and the epigenetic markers, with significant up-regulations of the BRMS1 and BAX. In addition to the kinetic and MAP pathways, docking analysis confirmed that S. platensis binds with the highest affinity to the predicted active sites of the tumor receptor IL-F3, thereby validating its antitumor activity. In conclusion, great suppression in the virulence of lung cancer was reported following treatment with S. platensis, illustrating its suspected mechanism of action, safety profile, kinetic properties, molecular docking results, toxicity, and internal pathways.

Radiation-induced oral mucositis (OM) and dermatitis (RD) are common debilitating toxicities of radiotherapy (RT) for head and neck cancer (HNC) patients. While photobiomodulation (PBM) has shown promise in reducing severity of these adverse effects, in-clinic treatments pose logistic and financial challenges. This study assessed the feasibility and compliance of a home-use, self-applied near-infrared PBM device for the prevention and treatment of RT-induced OM and RD. This prospective, single-arm trial enrolled 20 HNC patients scheduled for intensity-modulated RT (IMRT) with or without concurrent chemotherapy. Seventeen patients were analyzed following exclusions. Participants self-administered PBM at home twice daily for 9-11 weeks, from RT initiation to four weeks post-RT. The primary outcome was compliance (≥ 50% of expected treatments). Secondary outcomes included incidence of severe (grade 3-4) OM and RD. 67% of the participants completed at least 50% of the prescribed PBM treatments. Overall, 60% of expected sessions were administered, surpassing the predefined compliance threshold. By week 3, 6% presented with severe OM and none with severe RD. At RT completion, 41% and 18% had severe OM and RD, respectively. Four weeks post-RT, no severe OM or RD were observed, with the majority presenting with no toxicity (grade 0). No device related adverse effects were reported, and patients reported high comfort and ease of use. Self-administered, home-use PBM is a feasible and well-tolerated approach that shows promise as pre-emptive treatment for RT induced OM and RD. Large-scale, randomized, placebo-controlled trials are needed to confirm these findings and evaluate long-term benefits. ClinicalTrials.gov Identifier: NCT05176834. Registration Date: December 13th, 2021.

This study investigated the association between income, tumor stage, and treatment in non-small cell lung cancer (NSCLC) patients, stratified by Eastern Cooperative Oncology Group performance status (ECOG-PS). Patients diagnosed with NSCLC between 2017 and 2022 were selected from the Netherlands Cancer Registry (N = 71,025). Median household income at postal code level served as a proxy for income. Logistic regression was used to investigate the association between income, tumor stage at diagnoses and treatment. All analyses were stratified by ECOG-PS (PS0-1 vs. PS2+). Patients with an intermediate or higher income were more likely to be diagnosed with a stage IV tumor compared with those with a lower income. This was seen in patients with PS0-1 (odds ratio [OR]intermediate_vs_lower: 1.13 [95% confidence interval [95% CI]: 1.08-1.18], ORhigher_vs_lower: 1.23 [1.18-1.29]) and PS2+ (ORintermediate_vs_lower: 1.19 [1.11-1.27], ORhigher_vs_lower: 1.30 [1.19-1.41]). In patients with PS0-1 and a stage II or III tumor, those with an intermediate or higher income more often received a cancer treatment (stage II ORintermediate_vs_lower: 1.47 [1.09-1.99], ORhigher_vs_lower: 1.54 [1.13-2.11], stage III ORintermediate_vs_lower: 1.20 [1.03-1.40], ORhigher_vs_lower: 1.30 [1.09-1.55]). In patients with PS0-1 and a stage IV tumor, those with an intermediate or higher income more often received immunotherapy (ORintermediate_vs_lower: 1.10 [1.02-1.19], ORintermediate_vs_lower: 1.30 [1.20-1.41]) and systemic treatment (ORintermediate_vs_lower: 1.29 [1.20-1.39], ORhigher_vs_lower: 1.50 [1.37-1.63]). The latter was also found in patients with PS2+ (ORintermediate_vs_lower: 1.22 [1.08-1.38], ORhigher_vs_lower: 1.42 [1.23-1.64]). We thereby showed that even in a country with a universal healthcare system, large differences can be seen in the treatments of NSCLC patients according to income.

Liquid biopsy noninvasively characterizes diseases by analyzing biomarker proteins in biofluids, which provide valuable insights into physiological and pathological processes. In this study, we conducted an analysis of the differences between atypical endometrial hyperplasia or endometrial cancer (AH/EC) patients after fertility-sparing treatment with different RNA-Seq-based endometrial receptivity test (rsERT) results ("receptive" versus "pre-receptive"), to investigate the proteomic connections among tissue, serum, and urine samples. Samples of endometrial tissue, serum, and urine from 40 rsERT "pre-receptive" and 10 rsERT "receptive" patients were analyzed for proteomic profiling. We integrated differentially expressed proteins from three sample types to investigate endometrial receptor (ER)-related molecular changes. Our findings indicated that both serum and urine proteomes can serve as indicators of functional changes in endometrial tissue. In serum, proteins associated with cholesterol metabolism, immune response, and coagulation exhibited a differential expression. In urine, proteins related to immune function and metabolic processes demonstrated varying levels of expression. The differentially expressed proteins in both serum and urine were associated with the immune response and metabolism. In conclusion, biofluids serve as a reflection of functional changes in endometrial tissue, which will facilitate a deeper understanding of endometrial receptivity and the discovery of potential clinical biomarkers.

Elderly non-small cell lung cancer (NSCLC) patients do not always benefit from standard treatments due to impaired organ function and/or multiple comorbidities. Our study aimed to determine the efficacy and safety of aumolertinib as a first-line therapy in NSCLC patients aged ≥65 and <65 years in clinical practice.We enrolled 100 patients with stage IIA-IVB epidermal growth factor receptor-mutant NSCLC who received aumolertinib alone as the first-line therapy. Efficacy and safety were compared between patients aged ≥65 and <65 years in different subgroups. The primary endpoint was the objective response rate (ORR). The secondary endpoints included progression-free survival (PFS), overall survival (OS), disease control rate (DCR), and safety.Overall, ORR and DCR were 76% and 98%, respectively. ORR was 69.4% and 82.4% for patients aged ≥ 65 and < 65 years, respectively (P = .27), and DCR was 98% and 98%, respectively (P = .93). The median PFS was 23.2 months. The median PFS was 26.9 months and 18.3 months in the ≥65 and <65 years groups, respectively (P = .377, and the median OS of all patients was 31.7 months. The median OS was 33.7 months and 30.7 months in the ≥65 and <65 years groups, respectively (P = .851). Adverse events were not statistically different between the 2 groups.The efficacy and safety profile of aumolertinib as a first-line therapy in elderly patients with epidermal growth factor receptor-mutant NSCLC were similar to those observed in the younger subgroup.

This study aimed to assess the prevalence and risk factors associated with late xerostomia and hyposalivation in head and neck cancer (HNC) patients after radiotherapy (RT). An observational, multicentric cross-sectional study was conducted on 260 HNC patients attending various radiation centers for follow up 1-year post-treatment. Clinical assessments included the Subjective Dry Mouth Score (SXI), Clinical Oral Dryness Score (CODS), and Unstimulated Salivary Flow Rate (UWS). Xerostomia was reported by 78% of patients, with higher severity in those over 50 years (Mean ± SD: 13.53 ± 1.09). Women showed lower salivary flow (UWS: r = 0.556, p < 0.0001) and higher xerostomia scores (SXI: r = 0.337, CODS: r = 0.359) than men. Tumor site correlated strongly with xerostomia (SXI: r = 0.894, p < 0.001), with oral cavity tumors showing more severe effects than nasopharyngeal tumors. Higher RT dose and fraction were negatively associated with UWS (r = -0.537, p < 0.0001) and positively correlated with SXI (r = 0.293) and CODS (r = 0.405, p < 0.0001). The regression models showed that xerostomia severity is significantly predicted by advanced tumor stage, female gender, older age, and higher radiation dose exposure. The study reveals a high prevalence of xerostomia and hyposalivation among HNC survivors. Increased xerostomia severity and decreased salivary flow were significantly associated with advanced tumor stage, higher radiation doses, and concurrent chemoradiotherapy. Understanding risk factors can guide early interventions and personalized management to enhance long-term oral health outcomes.