Cancer Research Articles

Application of PMS2 and MSH6 double-antibody detection in screening of mismatch repair deficient tumors

Objective: To investigate whether the immunohistochemical results of two markers PMS2 and MSH6 (2-MMR) could replace the four markers MLH1, PMS2, MSH2 and MSH6 (4-MMR) to detect mismatch repair deficient (dMMR) cancers. Methods: A retrospective analysis was conducted with summary of immunohistochemical data from 7 867 cases of gastric cancer, colorectal cancer, endometrial cancer, and other diseases in the Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China, from March 2018 to March 2023. The consistency of 2-MMR and 4-MMR results was examined. Microsatellite instability (MSI) and next-generation sequencing (NGS) were performed in patients with specific phenotypes. Results: The Cohen κ values of 2-MMR and 4-MMR in gastric cancer, colorectal cancer, endometrial cancer and other diseases were 0.88, 0.99, 0.88 and 1.00, respectively. The overall consistency, sensitivity and specificity were 0.97, 99.6%, and 100.0%, respectively. Both 2-MMR and 4-MMR could detect the difference between various clinicopathological features. 24 (0.3%) of the 7 867 patients were found to have a special phenotype of MMR, and 6 of them were selected for MSI and NGS molecular testing. MSI analysis showed MSI-H in all cases, while NGS found that 5 of them had MMR-related gene mutations and 1 had POLE p.S297F mutation. Conclusions: Compared with 4-MMR, 2-MMR has high consistency, specificity and sensitivity. The cases with special phenotype only account for extremely low proportion. Therefore, 4-MMR may be replaced with 2-MMR in dMMR screening.

NTRK gene fusion and molecular pathological characteristics of mismatch repair deficient colorectal cancer

Objective: To investigate the expression pattern of pan-TRK protein in colorectal cancers with NTRK gene fusion and mismatch repair deficient (dMMR) and to analyze its molecular pathological characteristics. Methods: A total of 117 dMMR colorectal cancers diagnosed in the Department of Pathology of Henan Provincial People's Hospital, Zhengzhou, China from 2020 to 2023 were collected. Immunohistochemistry (IHC), fluorescence in situ hybridization (FISH) and DNA/RNA-based next-generation sequencing (NGS) were used to detect pan-TRK protein expression and fusion partner genes in tumors, and to further explore the correlation between pan-TRK staining patterns and partner genes. Results: IHC and FISH were performed successfully in formalin-fixed paraffin-embedded tissues from 117 dMMR colorectal cancer patients. There were 15 (15/117, 12.8%) cases with positive pan-TRK, including 6 cases with strong staining in tumor cell membrane and cytoplasm, 2 cases with weakly granular staining in tumor cytoplasm, 2 cases with moderate dot-like staining in near 5% tumor cell nuclei, 1 case with moderately to strongly granular staining in the cytoplasm and membrane of tumor cells, 1 case with moderately to weakly granular staining in about 60% of the tumor cells, 1 case with strongly staining in about 1% of the tumor cells, 1 case with moderately to strongly staining in about 3% of the tumor cells and 1 case with diffuse, moderate para-nuclear dot-like and weakly perinuclear granular staining. NTRK1 gene disruption was detected in 6 cases (6/117, 5.1%) and consistent with diffusely strong expression of pan-TRK. Based on DNA/RNA NGS, it was further confirmed that the 6 cases with NTRK1 gene disruption all carried TPM3-NTRK1 fusion gene, and all had high microsatellite instability and high tumor mutation burden. No KRAS, NRAS, BRAF V600E or TP53 gene mutations were detected. Four patients carried frame shift mutations in RNF43. Other molecular changes included 3 cases with ROS1 gene mutation, 2 cases with BRAC, ALK, and EGFR gene mutations, 2 cases with ATM gene mutation, and 2 cases with KIT gene mutation. These were missense/frame shift mutations that were associated with no clinical significance. The nine pan-TRK-positive cases without NTRK gene fusion detected with DNA-based NGS were further confirmed with RNA-based NGS, and no NTRK gene fusion was found. The sensitivity and specificity of NTRK gene fusion detected using IHC were 100.0% and 92.5%, respectively. The sensitivity and specificity of diffusely strong membranous/cytoplasmic staining were both 100.0%. Conclusions: Pan-TRK protein has various expression patterns in dMMR colorectal cancer. Its diffusely strong expression is highly suggestive of NTRK1 gene fusion. TPM3-NTRK1 gene fusion is a common form of NTRK gene fusion in dMMR colorectal cancer.

Impact of triglyceride-glucose index on the long-term prognosis of advanced gastric cancer patients receiving immunotherapy combined with chemotherapy

BACKGROUND Gastric cancer (GC) is the fifth most common malignancy and the third leading cause of death worldwide. Despite advancements in immunotherapies, patient prognosis remains poor, necessitating the identification of key prognostic factors to optimize the treatment approaches. Insulin resistance, as indicated by the triglyceride glucose (TyG) index, is increasingly recognized for its impact on cancer progression and immune modulation, and its potential role in GC prognosis is of particular interest. AIM To investigate whether the TyG index, a surrogate marker of insulin resistance, can predict the prognosis of patients with advanced GC receiving immunotherapy combined with chemotherapy. METHODS This retrospective study included 300 patients with advanced GC who received sintilimab combined with chemotherapy. The patients were categorized into two groups according to high or low TyG index, and independent prognostic factors for overall survival (OS) were determined using Cox proportional hazards regression analysis, which led to the development of a nomogram model. RESULTS Of the included patients, 136 had a high TyG index and 164 had a low TyG index. The median progression-free survival of the high TyG index group was significantly longer than that of the low TyG index group. Similarly, the median OS of the high TyG index group was significantly longer than that of the low TyG index group. The objective response and disease control rates in the two groups were 18.38% vs 9.15% and 58.82% vs 46.95%, respectively. No significant difference was noted in the incidence of adverse reactions at any level between the two groups (P > 0.05). In multivariate analysis, the Eastern Cooperative Oncology Group score, programmed cell death ligand 1 expression, and TyG index acted as independent prognostic factors for OS. Of these factors, the hazard ratio of the TyG index was 0.36 (95% confidence interval: 0.36-0.55, P < 0.001), and the nomogram model re-emphasized its importance as the main predictor of patient prognosis, followed by programmed cell death ligand 1 expression and the Eastern Cooperative Oncology Group score. CONCLUSION The TyG index is a long-term predictor of the efficacy of immunotherapy combined with chemotherapy, and patients with a high index have a better prognosis.

Revolutionizing breast cancer monitoring: emerging hematocrit-based metrics- a narrative review

Breast cancer remains a leading global health concern, with significant strides made in early detection and treatment. However, effective long-term surveillance, particularly for recurrence and metastasis, remains a clinical challenge. Traditional methods like imaging and biopsy are often invasive, costly, and have limited sensitivity in detecting subtle changes during disease progression. Emerging evidence suggests that hematocrit-based metrics—measurements of the proportion of red blood cells (RBCs) in blood—could serve as valuable, minimally invasive biomarkers for monitoring breast cancer. This review highlights recent advancements in hematocrit-focused research and its potential role in revolutionizing breast cancer surveillance. Hematocrit dynamics reflect complex physiological processes influenced by cancer biology, including inflammation, angiogenesis, and treatment-induced bone marrow suppression. Alterations in hematocrit levels have been associated with prognostic outcomes, treatment responses, and early indications of recurrence in breast cancer patients. Coupled with other hematological and molecular markers, hematocrit offers a cost-effective and readily accessible tool to track disease status in real time. Recent technological innovations, such as point-of-care testing, artificial intelligence-driven data analysis, and microfluidic devices, are further advancing the applicability of hematocrit-based metrics in both clinical and remote monitoring settings.

Important role of lymphovascular and perineural invasion in prognosis of colorectal cancer patients with N1c disease

BACKGROUND Lymphovascular invasion (LVI) and perineural invasion (PNI) are associated with decreased survival in colorectal cancer (CRC), but its significance in N1c stage remains to be clearly defined. AIM To evaluate LVI and PNI as potential prognostic indicators in N1c CRC. METHODS We retrospectively identified 107 consecutive patients who had CRC with N1c disease radically resected at our hospital. Tumors were reviewed for LVI and PNI by one pathologist blinded to the patients’ outcomes. Disease-free survival (DFS), overall survival (OS) and cancer-specific survival (CSS) were determined using the Kaplan-Meier method, with LVI and PNI prognosis differences determined by multivariate analysis using the Cox multiple hazards model. Results were compared using log-rank test. The receiver operating characteristic (ROC) curve was used to evaluate the prognostic predictive ability. RESULTS The median follow-up time was 63.17 (45.33-81.37) months for DFS, with 33.64% (36/107) of patients experiencing recurrence; 21.5% of tumors were found to be LVI positive and 44.9% PNI positive. The 5-year DFS rate was greater for patients with LVI-negative tumors compared with LVI-positive tumors (74.0% vs 35.6%), and PNI was similar (82.5% vs 45.1%). On multivariate analysis, LVI [hazard ratio (HR) = 3.368, 95% confidence interval (CI): 1.628-6.966, P = 0.001] and PNI (HR = 3.055, 95%CI: 1.478-6.313, P = 0.002) were independent prognostic factors for DFS. All patients could be divided into three groups of patients with different prognosis according to LVI and PNI. The 5-year ROC curve for LVI, PNI and their combination prediction of DFS was 0.646, 0.709 and 0.759, respectively. Similar results were seen for OS and CSS. CONCLUSION LVI and PNI could serve as independent prognostic factors of outcomes in N1c CRC patients. Patients with LVI or PNI should be given more attention during treatment.

Lichen Sclerosus in Cancer Patients.

To characterize the association between cancer therapies and the development of lichen sclerosus (LS) in a case series of patients. A retrospective chart review was performed to screen for patients who were diagnosed with LS while undergoing cancer therapy at Memorial Sloan Kettering Cancer Center between 2003 and 2019. Patients were excluded if they had been diagnosed with LS prior to starting cancer therapy. Clinical and treatment characteristics were analyzed. The final study sample included 29 female patients who developed LS in the setting of systemic cancer therapy. Median time to LS onset after cancer therapy initiation was 420 days. Primary tumor types included breast (10, 34.5%), gynecologic (8, 27.6%), gastrointestinal (5, 17.2%), cutaneous (2, 6.9%), lung (2, 6.9%), and hematologic (2, 6.9%). Cancer therapy regimens included hormonal therapy (10, 34.5%), chemoradiation (7, 24.1%), cytotoxic chemotherapy (7, 24.1%), PD-1/PD-L1 inhibitors (3, 10.3%), local radiation (1, 3.4%), and allogeneic stem cell transplant (1, 3.4%). Across all patients, the mean number of treatments for LS was 2.8. Twenty-three (79.3%) patients received the first-line therapy of ultrapotent topical steroids, but 16 (69.6%) required additional topical and systemic treatment. Limitations include retrospective design and referral bias. Breast cancer was the most common primary tumor among patients in this study. The most common cancer therapy regimen was hormonal therapy. Most patients required an escalation in therapy to manage their LS. For patients undergoing cancer treatment, concomitant LS management can present unique challenges due to the biological mechanism of some anticancer therapies and the pathophysiology of LS. There is limited data to guide treatment of LS for this population. Some of the patients included in this analysis had progression of LS and recurrence of cancer while undergoing management of both conditions, necessitating close follow-up.

Evaluating the Characteristics of the Totally Implantable Venous Access Device in Cancer Patients Using Fluorodeoxyglucose-PET/CT in the Absence of Suspected Catheter-Related Infections

Evaluating the Characteristics of the Totally Implantable Venous Access Device in Cancer Patients Using Fluorodeoxyglucose-PET/CT in the Absence of Suspected Catheter-Related Infections

Gamma-H2AX as a biomarker to assess individual radiosensitivity for radiopharmaceutical therapy in cancer patients: A systematic review

Radiopharmaceutical therapy offers targeted, potent cancer treatment, but individual responses vary, necessitating personalized approaches for optimal outcomes. Gamma-H2AX, a phosphorylated form of histone, has become a sensitive indicator of DNA double-strand breaks caused by ionizing radiation. Gamma-H2AX assays in radiopharmaceutical therapy offer a non-invasive way to assess individual radiosensitivity, improving treatment optimization and patient classification. This systematic review examines the use of gamma-H2AX as a biomarker for determining individual radiosensitivity in cancer patients receiving radiopharmaceutical therapy. An in-depth search for supporting publications utilized three popular electronic databases: PubMed Central (PMC), ScienceDirect, and Scopus. Specific keywords determine article limits. Every existing article was examined and appraised independently using the PICO method (participants, intervention/exposure, comparison, and outcome). 81 articles were identified, 59 were screened based on title and abstract, and 32 were excluded. Six articles were quite worthy, but only two articles were considered in this research. Based on these two articles, it is possible to conclude that the gamma-H2AX foci marker in peripheral blood cells of patients receiving radiopharmaceutical therapy was promising for predicting treatment response and individual radiosensitivity. However, this research needs to be validated with a greater number of patients to have a higher prospective value in future investigations.

Targeted generative data augmentation for automatic metastases detection from free-text radiology reports

Automatic identification of metastatic sites in cancer patients from electronic health records is a challenging yet crucial task with significant implications for diagnosis and treatment. In this study, we demonstrate how advancements in natural language processing, namely the instruction-following capability of recent large language models and extensive model pretraining, made it possible to automate metastases detection from radiology reports texts with a limited amount of gold-labeled data. Specifically, we prompt Llama3, an open-source instruction-tuned large language model, to generate synthetic training data to expand our limited labeled data and adapt BERT, a small pretrained language model, to the task. We further investigate three targeted data augmentation techniques which selectively expand the original training samples, leading to comparable or superior performance compared to vanilla data augmentation, in most cases, while being substantially more computationally efficient. In our experiments, data augmentation improved the average F1-score by 2.3, 3.5, and 3.9 points for lung, liver, and adrenal glands, the organs for which we had access to expert-annotated data. This observation suggests that Llama3, which has not been specifically tailored to this task or clinical data in general, can generate high-quality synthetic data through paraphrasing in the clinical context. We also compare metastasis identification accuracy between models utilizing institutionally standardized reports vs. non-structured reports, which complicate the extraction of relevant information, and show how including patient history with a customized model architecture narrows the gap between those two setups from 7.3 to 4.5 points on F1-score under LoRA tuning. Our work delivers a broadly applicable solution with remarkable performance that does not require model customization for each institution, making large-scale, low-cost spatio-temporal cancer progression pattern extraction possible.

Navigation as a system approach: A qualitative descriptive study to inform a statewide cancer navigation approach in Australia.

This study aimed to identify challenges and facilitators in accessing cancer care in South Australia, from the perspectives of cancer survivors and caregivers, to inform responsive cancer navigation approaches. A qualitative descriptive study was conducted using an online qualitative survey (n = 75) and video, phone, and in-person semi-structured interviews (n = 22) with cancer survivors and caregivers (herein cancer consumers). Data analysis was performed in two phases: content analysis categorised consumer challenges and facilitators, while a subjective-inductive approach guided by the supportive care framework was used to develop a statewide navigation approach. Key challenges reported by consumers included perceived invalidation of medical concerns, delayed diagnoses, poor communication, inadequate information provision, fragmented care, and limited logistical, cultural, and psychological support. Inductive analysis identified four key themes: 1) cancer consumers have dynamic care needs that can evolve throughout a patient's cancer experience, 2) cancer consumers require a foundational level of information to support navigation, 3) some cancer consumers express a preference for community-based navigation services to help them manage their care, and 4) individuals with more complex care needs may require more intensive professional navigation services. A conceptual needs-based navigation approach (the Flinders Needs-Based Approach to Cancer Navigation)was developed based on these insights. This approach consists of three levels of navigation interventions: level 1 involves providing information-based navigation to all individuals affected by cancer, level 2 involves community-based navigation support offered to those requiring or wanting additional supported assistance, and level 3 offers professional navigation for individuals with complex needs. Our study highlights the importance of tailoring cancer navigation services to meet the evolving needs of patients, emphasising the role of both community and professional support, particularly for individuals with complex care requirements. Findings will inform further co-design discussions involving consumers, health professionals, and policymakers to implement cancer navigation services across South Australia.

Exploring the Therapeutic Potential of Artemisia and Salvia Genera in Cancer, Diabetes, and Cardiovascular Diseases: A Short Review of Clinical Evidence

Metabolic syndrome, a cluster of metabolic disorders comprising dyslipidemia, insulin resistance, elevated blood pressure, and abdominal obesity, is a silent epidemic that may lead to outcomes such as cardiovascular disease, diabetes, and cancer. Due to the increase in the prevalence of these pathologies, the search for better treatments and more efficient drugs is imperative. Species of Artemisia and Salvia genera are excellent examples of noteworthy sources of bioactive products with health applications, their therapeutic properties being well known both in popular medicine and in the scientific community. There are reports of plant extracts or compounds from species belonging to either of these genera, which were able to combat cancer, diabetes, and cardiovascular pathologies. For instance, dihydroartemisinin (analog of artemisin extracted from Artemisia annua L.) can reduce tumor markers p53 and Ki-67 expression levels, leading to a reduction in tumor proliferation. Salvia officinalis L. has antihyperglycemic and lipid profile-improving effects since it decreases total cholesterol, glycosylated hemoglobin, fasting glucose, low-density lipoprotein cholesterol, and triglyceride levels while increasing high-density lipoprotein cholesterol levels. Clinical trials using mixtures (dried powdered plants or extracts) of known medicinal plants are recurrent in published works, in contrast with the scarce clinical trial studies with isolated compounds. Salvia miltiorrhiza Bunge. was by far the most targeted plant in the clinical trials analyzed here. Regarding clinical trials concerning Artemisia, there are more studies aiming to see its effect on diabetes, but the studies about cancer are more advanced. This review aims to give a critical summary of the most interesting and promising results from clinical trials. The abundance of studies with limited statistically significant clinical evidence hinders progress in clinical therapy. This situation demands far greater rigor from the scientific community, researchers, regulatory agencies, editors, and reviewers in conducting and publishing clinical studies.

HTT, ATXN1 and ATXN2 CAG triplet repeat sizes: exploring their role in the disease risk and cancer comorbidity in Parkinson’s disease

Abstract Parkinson's disease (PD) genetic embraces genetic and non-genetic factors. It has been suggested a link between CAG repeat number in the HTT, ATXN1 and ATXN2 genes and different neurodegenerative diseases. Several genetic factors involved in PD development are indeed associated with cancer pathways. Moreover, several studies found a low prevalence of cancer in neurodegenerative diseases that can be associated with a low CAG repeat size in several genes. This study aimed to investigate the influence of CAG repeat sizes in ATXN1, ATXN2, and HTT genes on the risk for developing cancer and PD disease in a large cohort of idiopathic PD patients and healthy controls. The work included 1052 idiopathic PD patients and 1070 controls of European ancestry. CAG repeat sizes in HTT, ATXN1, and ATXN2 genes were analysed. Dunn’s Multiple Comparison Test for quantitative variables and logistic and linear regression were used. The long ATXN1 and HTT alleles and CAG size, and both the ATXN2 short and long alleles were predictors for the PD risk. The long CAG ATXN1 allele gene was associated with the risk of cancer. No association was observed between CAG size in the HTT and ATXN2 genes and risk of cancer in PD patients. We described an association of HTT, ATXN1 and ATXN2 with the risk of PD which reinforce the hypothesis of the common pathway of neurodegeneration. Besides, ATXN1 could be a predictor of cancer risk among PD patients and these results suggest that cancer and neurodegeneration processes can share common pathways.

Agreement on the Prevalence of Body Mass Index (BMI) in Mexican Children and Adolescents Using Different International References

(1) Background: Obesity and overweight are defined as an abnormal or excessive accumulation of fat that can be harmful to health. These are conditions that can lead to a lifetime of diseases, including cancer, diabetes, and heart disease. The diagnosis of overweight and obesity in children and adolescents depends on the international reference used. (2) Objectives: In this study aimed to determine the level of concordance of the prevalence of underweight, normal weight, overweight, and obesity were estimated with three international references in Mexican children and adolescents between 2 and 18 years of age. (3) Methods: We used specific the body mass index (BMI) cut-off points of the ENSANUT Continua 2022 database. The weight category was measured using the World Health Organization (WHO) criteria (<−2 standard deviation (SD), underweight; −2 and +0.99 SD, normal weight; +1 and +1.99 SD, overweight; and ≥+2 SD, obesity); Centers for Disease Control and Prevention (CDC) criteria (<percentile 5, underweight; percentile 5 and <percentile 85, normal weight; ≥percentile 85, overweight; and ≥percentile 95, obesity); and the Obesity Task Force (IOTF) criteria (specific limit values). To determine agreement among these three criteria, Cohen’s Kappa index was used. (4) Results: There were differences in the estimation of weight categories according to the international reference used. Substantial (WHO-IOTF: 0.639; CDC-IOTF: 0.785) and almost perfect (WHO-CDC: 0.806) levels of agreement were found between the references used; however, agreement varied according to age. (5) Conclusions: The weight category depends on the reference used, so each one should be used with caution since the results inform our actions of prevention, surveillance, and the control of nutrition in childhood and adolescence for the timely detection of chronic health problems and effects of social deficiencies.

Retraction Note: Emerging therapies and their impact on neurosurgical practice: a focus on cancer and infectious diseases.

Retraction Note: Emerging therapies and their impact on neurosurgical practice: a focus on cancer and infectious diseases.

Combined protein and transcriptomics identifies DCTPP1 as a putative biomarkers for predicting immunotherapy responsiveness in gastric cancer patients.

This study aimed to screen the changes after overexpression of dCTP pyrophosphatase 1 (DCTPP1) in human gastric adenocarcinoma cells (AGS) cells by proteome and transcriptome sequencing. Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analysis were performed to explore the functional significance of the differentially expressed DCTPP1 in gastric cancer (GC). Cell Counting Kit-8 (CCK-8) assay was used to detect the proliferation of cells. Western blot was used to detect the expression of proteins. A total of 28 genes that were significantly associated with DCTPP1 overexpression and had prognostic value were screened by Cox regression analysis. The results of gene set enrichment analysis showed that the genomes of patients with subtype A exhibited significant enrichment in pathways such as DNA repair, pyrimidine synthesis, and glucose metabolism. The tumor immune dysfunction and exclusion and The Cancer Immunome Atlas databases showed that patients with type A GC were better candidates for immunotherapy than patients with type B GC. Furthermore, the CCK-8 assay indicated significantly enhanced proliferative activity after overexpressing DCTPP1 in AGS cells, corroborating the findings from the bioinformatic analysis. The data suggest a potential association between DCTPP1 expression and both the prognosis of GC patients and the efficacy of immunotherapy. These findings offer valuable insights for the potential optimization of therapeutic strategies in gastric cancer.

Retraction Note: Single-cell omics and machine learning integration to develop a polyamine metabolism-based risk score model in breast cancer patients.

Retraction Note: Single-cell omics and machine learning integration to develop a polyamine metabolism-based risk score model in breast cancer patients.

The association between the circadian misalignment of serum cortisol acrophase and sleep end time with chemotherapy-induced peripheral neuropathy

ABSTRACT Chemotherapy-induced peripheral neuropathy (CIPN) is a common adverse effect of chemotherapy. The objective of this prospective observational study was to examine the association between circadian misalignment (CM), as measured by phase angle difference (PAD) of biological and behavioral rhythms and CIPN. The PAD of cortisol acrophase and actigraphy-based sleep end time in breast cancer patients was measured and categorized into low PAD (n = 11) and high PAD (n = 12) groups based on median value. CIPN was assessed using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-CIPN20 (CIPN20). The assessment of CM revealed that the sleep end time of the low PAD group was more delayed in relation to cortisol acrophase compared to the high PAD group. The low PAD group demonstrated significantly higher CIPN20 global and sensory scale scores compared to the high-PAD group at one month post-chemotherapy, with an estimated group difference of 17.63 ± 4.75 and 27.07 ± 6.70 (p = 0.001 and p < 0.001, respectively). The present findings indicate that the low PAD group, which exhibited a relatively delayed behavioral rhythm with respect to its biological rhythm, displayed an increased susceptibility to CIPN. Further large-sample research is necessary to attain a comprehensive understanding of the mechanisms through which CM affects CIPN.

Clinical efficacy and safety of sintilimab plus oral vinorelbine as first-line treatment for newly diagnosed stage IIIB–IV nonsmall cell lung cancer patients with performance status 2 or age ≥75 years

This study aimed to evaluate the efficacy and safety of sintilimab combined with oral vinorelbine in newly diagnosed patients with stage IIIb to IV nonsmall cell lung cancer (NSCLC) who had an Eastern Cooperative Oncology Group performance status (PS) of 2 or over 75 years of age during the initial treatment. This prospective single-center single-arm study enrolled patients with histologically confirmed NSCLC. Eligible patients were administered sintilimab and vinorelbine. The primary endpoint was progression-free survival (PFS), and the secondary endpoints included objective response rate (ORR) and disease control rate (DCR). Furthermore, this study assessed indicators of treatment response and safety. From September 2020 to December 2023, 60 eligible patients were enrolled in the Respiratory Department of Shanxi Cancer Hospital. Following treatment, PFS was 9.1 months, and ORR and DCR were 39.6 and 63.79%, respectively. In addition, there was a reduction in blood tumor marker levels and enhanced immune function. Adverse reactions had a relatively low incidence and primarily consisted of grade 1–2 cases. Sintilimab plus oral vinorelbine showed promising efficacy and safety as a first-line treatment strategy for patients with NSCLC with PS 2 or elderly patients. It also optimizes immune function in patients with NSCLC.

Different exercise interventions on quality of sleep in breast cancer survivors—a network meta-analysis of randomized controlled trials

IntroductionBreast cancer is currently the most prevalent cancer globally; however, it generally has a favorable prognosis and is linked to a high survival rate. While effective treatments can extend survival and mitigate associated side effects, not all survivors are exempt from complications. Notably, a significant proportion of survivors experience sleep disorders following surgery, which can severely impact their quality of life. Exercise is frequently recommended as a non-pharmacological intervention to enhance sleep quality among breast cancer survivors and may also play a role in reducing recurrence rates. Recognizing that various forms of exercise may yield different outcomes in addressing sleep disorders in this population, we conducted a network review meta-analysis to assess the effectiveness of diverse exercise modalities for breast cancer survivors suffering from sleep disturbances.MethodsWe searched four electronic databases for randomized controlled trials of individuals diagnosed breast cancer with sleep disorders by different exercise therapy. The primary outcomes included Yoga, Pilates, Qigong, Tai Chi, Walking, Dance, Resistance training, Football, Virtual reality therapy, Activity change exercise, Software-guided exercises. The methodological quality of the included studies was assessed using the Cochrane Bias risk Assessment tool, and network meta-analysis was performed using Stata15 software. The review was pre-registered (PROSPERO ID: CRD42023442892).ResultsData on 3083 breast cancer survivors with sleep disturbances from 34 eligible randomized controlled trials were analyzed, with 23 classified as medium risk and 2 as high risk. Network meta-analysis showed that walking exercise [Standard Median Different (SMD) =3.06, 95% Confidence Interval (95%CI)=(-5.89,-0.23)] significantly improved sleep disorder (Surface Under the Cumulative Ranking curve, SUCRA: 84.5%) and reduced Pittsburgh sleep quality index (PSQI) score.DiscussionBased on the network ranking table, we can conclude that walking exercise offers greater benefits compared to other exercise interventions for improving sleep quality in breast cancer patients. This finding presents a novel perspective on exercise interventions for breast cancer survivors experiencing sleep disorders.Systematic review registrationPROSPERO https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=442892, identifier CRD42023442892.

Predictors of survival rates among breast cancer patients in Ethiopia: a systematic review and meta-analysis 2024

IntroductionBreast cancer remains the most common cancer and a leading cause of cancer-related deaths among women worldwide. In Ethiopia, the survival rate of breast cancer patients is influenced by various socio-demographic, clinical, and health system factors. This systematic review and meta-analysis aimed to identify and synthesize the predictors of survival rates among breast cancer patients in Ethiopia.MethodsWe conducted a systematic review of observational cohort studies. The literature search was performed between August 1 and 30, 2024, using PubMed, Hinari, EMBASE, Google, Google Scholar, and Web of Science. The Newcastle Ottawa 2016 Critical Appraisal Checklist assessed methodological quality. Publication bias was evaluated using a funnel plot and Egger’s test, and heterogeneity was examined with the I-squared test. Data were extracted with Microsoft Excel and analyzed using Stata 11.ResultsA total of 15 articles with 6,375 study participants from six regions were included. We found that significant predictors of decreased survival rate among breast cancer patients were age (aHR 1.05, 95% CI 1.02–1.08), illiteracy (aHR 7.34, 95% CI 4.38–10.3), married (aHR 1.21, 95% CI 1.03–1.40), rural residence (aHR 1.71, 95% CI 1.06–2.36), two or more lymph node involvement (aHR 3.57, 95% CI 1.02–6.13), histological grade two or more (aHR 1.44, 95% CI 1.12–2.77), overweight (aHR 0.56, 95% CI 0.24–0.87), and having comorbidity (aHR 1.86, 95% CI 1.04–2.68).ConclusionThis systematic review and meta-analysis identified several key predictors of reduced survival rates among breast cancer patients in Ethiopia, including older age, illiteracy, rural residence, involvement of two or more lymph nodes, higher histological grade, marital status, and the presence of comorbidities. Interestingly, being overweight was associated with improved survival. Health stakeholders and policymakers emphasizing public health education, managing comorbidities, and expanding access to early detection and treatment, especially in rural areas, are critical.