Differences in disease status between patients with progression after first-line chemotherapy versus early relapse after adjuvant chemotherapy who undergo second-line chemotherapy for gastric cancer: Exploratory analysis of the randomized phase III TRICS trial

Relationships among microbiota, gastric cancer, and immunotherapy

Currently, conventional neoadjuvant therapy or postoperative adjuvant therapy, such as chemotherapy and radiation therapy, can only bring limited survival benefits to gastric cancer (GC). Median survival after palliative chemotherapy is also low, at about 8-10 months. Immunotargeting is a new option for the treatment of GC, but has not been widely replicated. The highly immunosuppressed tumor microenvironment (TME) discounts the efficacy of immunotherapy for GC. Therefore, new strategies are needed to enhance the immune response of the TME. This paper reviewed the relationship between microorganisms and GC, potential links between microorganisms and immunotherapy and research of microorganisms combined immunotherapy.

Development and Validation of Noninvasive MRI-Based Signature for Preoperative Prediction of Early Recurrence in Perihilar Cholangiocarcinoma

BACKGROUND

Cholangiocarcinoma is a type of hepatobiliary tumor. For perihilar cholangiocarcinoma (pCCA), patients who experience early recurrence (ER) have a poor prognosis. Preoperative accurate prediction of postoperative ER can avoid unnecessary operation; however, prediction is challenging.

PURPOSE

To develop a novel signature based on clinical and/or MRI radiomics features of pCCA to preoperatively predict ER.

STUDY TYPE

Retrospective.

POPULATION

One hundred eighty-four patients (median age, 61.0 years; interquartile range: 53.0-66.8 years) including 115 men and 69 women.

FIELD STRENGTH/SEQUENCE

A 1.5 T; volumetric interpolated breath-hold examination (VIBE) sequence.

ASSESSMENT

The models were developed from the training set (128 patients) and validated in a separate testing set (56 patients). The contrast-enhanced arterial and portal vein phase MR images of hepatobiliary system were used for extracting radiomics features. The correlation analysis, least absolute shrinkage and selection operator (LASSO) logistic regression (LR), backward stepwise LR were mainly used for radiomics feature selection and modeling (Modelradiomic ). The univariate and multivariate backward stepwise LR were used for preoperative clinical predictors selection and modeling (Modelclinic ). The radiomics and preoperative clinical predictors were combined by multivariate LR method to construct clinic-radiomics nomogram (Modelcombine ).

STATISTICAL TESTS

Chi-squared (χ2 ) test or Fisher's exact test, Mann-Whitney U-test or t-test, Delong test. Two tailed P < 0.05 was considered statistically significant.

RESULTS

Based on the comparison of area under the curves (AUC) using Delong test, Modelclinic and Modelcombine had significantly better performance than Modelradiomic and tumor-node-metastasis (TNM) system in training set. In the testing set, both Modelclinic and Modelcombine had significantly better performance than TNM system, whereas only Modelcombine was significantly superior to Modelradiomic . However, the AUC values were not significantly different between Modelclinic and Modelcombine (P = 0.156 for training set and P = 0.439 for testing set).

DATA CONCLUSION

A noninvasive model combining the MRI-based radiomics signature and clinical variables is potential to preoperatively predict ER for pCCA.

LEVEL OF EVIDENCE

3 TECHNICAL EFFICACY STAGE: 4.