Cancer statistics, 2019

Coping strategies and psychological distress in postoperative recovery: A repeated-measures study in women undergoing breast-conserving surgery

Objective

Breast-conserving surgery (BCS) is the standard treatment for early-stage breast cancer, yet patients often experience significant psychological distress and physical symptoms during recovery. This study aimed to explore the relationships between antecedents, physical symptoms (pain and nausea), psychological distress, and coping strategies utilized by women recovering from BCS to improve management of postoperative challenges.

Methods

This repeated-measures descriptive study involved 75 women who underwent BCS with sentinel lymph node biopsy at a National Cancer Institute-designated center. Participants completed the National Comprehensive Cancer Network (NCCN) Distress Thermometer and Ways of Coping Instrument on Postoperative Day 1 (POD1) and POD14. Bivariate analyses, multiple linear regression, and structural equation modeling were conducted to evaluate associations between antecedents, coping strategies, and distress. Open-ended responses were qualitatively analyzed for thematic content.

Results

Seeking social support (POD1 mean ​= ​1.25; POD14 mean ​= ​1.20) and planful problem-solving (POD1 mean ​= ​1.19; POD14 mean ​= ​1.04) were the most frequently used coping strategies, while accepting responsibility and confrontive coping were least utilized. Overall coping strategy use decreased between POD1 and POD14, likely reflecting recovery adaptation. Significant predictors of distress included escape-avoidance coping (β ​= ​0.415, P ​< ​0.001), social support (β ​= ​0.270, P ​= ​0.02), history of nausea (β ​= ​0.517, P ​< ​0.001), and age (β ​= ​0.293, P ​= ​0.007). Coping strategies did not mediate the relationship between antecedents and distress.

Conclusions

Adaptive coping strategies such as social support and planful problem-solving play a critical role in mitigating distress during BCS recovery. Interventions should emphasize fostering these strategies and addressing high-risk groups, such as younger patients and those with a history of nausea. Despite limitations, this study underscores the importance of supporting adaptive coping to improve postoperative outcomes and provides a basis for future research.

Barriers to implementation of preoperative urostomy site marking in nurse-physician cooperation: A qualitative study based on the Theoretical Domains Framework

Objective

This study aimed to understand the barriers to nurse-physician collaboration in implementing preoperative stoma site marking using qualitative research methods following Theoretical Domain Framework.

Methods

A qualitative descriptive study using semi-structured interviews was conducted from March to June 2023 in the urology departments of nine tertiary hospitals in China. Twelve urologists and eight enterostomal therapists (ETs) were recruited using purposive sampling. Audio recordings were transcribed verbatim and data were analyzed using content analysis.

Results

Five themes were identified in the study: shortage of manpower and stoma care products, lack of standard and regulations, lack of motivation and intention, inconsistency of expectation on consequences, and difficulties in cooperation.

Conclusion

This study indicated that the barriers to implementation of preoperative urostomy localization among urologists and ETs. Institutions, resources, clear career plans, and performance feedback can increase motivation and intention. In addition, the lack of cooperation between urologists and ETs is a key factor for poor urostomy localization implementation, which calls for effective and equal communication between doctors and nurses.

Time to progression predicts outcome of patients with multiple myeloma that can be influenced by autologous hematopoietic stem cell transplantation

OBJECTIVES

Currently, there is limited understanding regarding the prognostic significance of time to progression (TTP) after first remission in multiple myeloma (MM).

METHODS

We conducted a retrospective analysis of clinical data from 209 patients with MM. These patients were categorized into ≤ 6 months, ≤ 12 months, ≤ 24 months, > 24 months, 6-12 months, and 12-24 months subgroups based on TTP.

RESULTS

Patients in ≤ 12 months group exhibited shorter median overall survival (OS) and OS-1 compared to those in ≤ 24 months group (61.73 vs 96.10 months, P = 0.02; 54.00 vs 74.17 months, P = 0.048). ≤ 6 months group exhibited shorter median OS and OS-1 compared to 6-12 months group (33.63 vs 79.60 months, P = 0.022; 19.93 vs 65.17 months, P = 0.015). Patients in 6-12 months group had shorter median OS and OS-1 compared to those in 12-24 months group (79.60 vs 100.43 months, P < 0.001; 65.17 vs 77.17 months, P = 0.012).No significant difference in OS was observed between patients in 12-24 months and > 24 months groups. For patients who experienced progression within 12 or 24 months after remission, undergoing autologous hematopoietic stem cell transplantation (ASCT) after progression conferred a median OS and OS-2 advantage over receiving post-progression chemotherapy. Multivariable analysis confirmed that TTP was an independent predictor for OS in patients with MM.

CONCLUSION

Patients with MM who experience earlier disease progression within 12 months after remission have a worse prognosis, and post-progression ASCT can improve their survival outcomes.

The Digital Revolution in Medicine: Applications in Cardio-Oncology

PURPOSE OF REVIEW

A critical evaluation of contemporary literature regarding the role of big data, artificial intelligence, and digital technologies in precision cardio-oncology care and survivorship, emphasizing innovative and groundbreaking endeavors.

RECENT FINDINGS

Artificial intelligence (AI) algorithm models can automate the risk assessment process and augment current subjective clinical decision tools. AI, particularly machine learning (ML), can identify medically significant patterns in large data sets. Machine learning in cardio-oncology care has great potential in screening, diagnosis, monitoring, and managing cancer therapy-related cardiovascular complications. To this end, large-scale imaging data and clinical information are being leveraged in training efficient AI algorithms that may lead to effective clinical tools for caring for this vulnerable population. Telemedicine may benefit cardio-oncology patients by enhancing healthcare delivery through lowering costs, improving quality, and personalizing care. Similarly, the utilization of wearable biosensors and mobile health technology for remote monitoring holds the potential to improve cardio-oncology outcomes through early intervention and deeper clinical insight. Investigations are ongoing regarding the application of digital health tools such as telemedicine and remote monitoring devices in enhancing the functional status and recovery of cancer patients, particularly those with limited access to centralized services, by increasing physical activity levels and providing access to rehabilitation services.

SUMMARY

In recent years, advances in cancer survival have increased the prevalence of patients experiencing cancer therapy-related cardiovascular complications. Traditional cardio-oncology risk categorization largely relies on basic clinical features and physician assessment, necessitating advancements in machine learning to create objective prediction models using diverse data sources. Healthcare disparities may be perpetuated through AI algorithms in digital health technologies. In turn, this may have a detrimental effect on minority populations by limiting resource allocation. Several AI-powered innovative health tools could be leveraged to bridge the digital divide and improve access to equitable care.

An in-depth study of clofarabine's binding mechanism to DNA: A thorough experimental and theoretical investigation

The interaction of medicinal compounds with nucleic acids is a critical challenge in drug development. This research focused on the binding dynamics of clofarabine (CLO), an antineoplastic agent, with fish sperm DNA (dsDNA) under conditions that simulate the physiological environment at a pH of 7.4. The investigations employed multiple techniques, including fluorescence and UV spectroscopy, thermal denaturation analysis, viscosity measurements, electrochemical assessments, and molecular docking studies to elucidate these binding interactions. The binding constant (Kb) for the interaction between CLO and dsDNA, as determined from the Benesi-Hildebrand plot, was found to be 2.74 × 104 at a temperature of 298 K. The entropy (∆S) and enthalpy (∆H) changes associated with this binding interaction were measured as + 43.08 J mol-1 K-1 and -12.44 kJ mol-1, respectively. These values indicate that the predominant forces driving the binding interaction are primarily due to hydrogen bonding. Studies using the ethidium bromide and the Hoechst probe showed that CLO does not bind to dsDNA intercalatively. Findings obtained through UV-Vis absorption spectroscopy, competitive binding assays, and viscosity assessments indicated that CLO associates with dsDNA by binding within the minor groove. Molecular docking analyses demonstrated that CLO is accommodated within the AT-rich segment of the minor groove, with significant hydrogen bonding interactions occurring between CLO and dsDNA. These findings may offer valuable perspectives for elucidating the mechanisms underlying the toxicity, resistance, and adverse effects associated with CLO.

Nano biosensor unlocks tumor derived immune signals for the early detection of ovarian cancer

Ovarian cancer is a critical health issue for women nowadays. Its impact is significant because of its high mortality rate (324,603 worldwide), late-stage diagnosis and poor survival rate. Lack of screening tests, vague symptoms, misdiagnosis, and age factor makes it even more difficult to detect. Neutrophils, a subset of immune cells, undergo tumor-specific changes as ovarian cancer progresses inside ovarian tumour microenvironment. Therefore, monitoring the time-specific activity of neutrophils in circulation has the potential to aid in the diagnosis of ovarian cancer. Most ovarian tumor-specific antigens are unknown, making it difficult to identify neutrophils associated with ovarian tumor. We present ovarian tumor-associated circulating neutrophil cell profiling as a stand-alone cancer diagnostic method using a liquid biopsy. Using a SERS-functionalized nano probe, the metabolic profiles of neutrophils from ovarian tumor interaction are detected. We demonstrate that neutrophils associated with cancer stem cells have a distinct metabolic profile and are useful in the diagnosis of early ovarian cancer. Using 5 μL of peripheral blood and an artificial neural network, the characteristics of neutrophil profiles in patient blood could distinguish cancer cohort from non-cancer (healthy) with a 90 % sensitivity and 100 % specificity. Our results demonstrate the viability of using circulating neutrophils for non-invasive cancer diagnostics.

Cannabis use disorder and severe sepsis outcomes in cancer patients: Insights from a national inpatient sample

BACKGROUND

The burden of cannabis use disorder (CUD) in the context of its prevalence and subsequent cardiopulmonary outcomes among cancer patients with severe sepsis is unclear.

AIM

To address this knowledge gap, especially due to rising patterns of cannabis use and its emerging pharmacological role in cancer.

METHODS

By applying relevant International Classification of Diseases, Ninth and Tenth Revision, Clinical Modification codes to the National Inpatient Sample database between 2016-2020, we identified CUD(+) and CUD(-) arms among adult cancer admissions with severe sepsis. Comparing the two cohorts, we examined baseline demographic characteristics, epidemiological trends, major adverse cardiac and cerebrovascular events, respiratory failure, hospital cost, and length of stay. We used the Pearson χ² d test for categorical variables and the Mann-Whitney U test for continuous, non-normally distributed variables. Multivariable regression analysis was used to control for potential confounders. A P value ≤ 0.05 was considered for statistical significance.

RESULTS

We identified a total of 743520 cancer patients admitted with severe sepsis, of which 4945 had CUD. Demographically, the CUD(+) cohort was more likely to be younger (median age = 58 vs 69, P < 0.001), male (67.9% vs 57.2%, P < 0.001), black (23.7% vs 14.4%, P < 0.001), Medicaid enrollees (35.2% vs 10.7%, P < 0.001), in whom higher rates of substance use and depression were observed. CUD(+) patients also exhibited a higher prevalence of chronic pulmonary disease but lower rates of cardiovascular comorbidities. There was no significant difference in major adverse cardiac and cerebrovascular events between CUD(+) and CUD(-) cohorts on multivariable regression analysis. However, the CUD(+) cohort had lower all-cause mortality (adjusted odds ratio = 0.83, 95% confidence interval: 0.7-0.97, P < 0.001) and respiratory failure (adjusted odds ratio = 0.8, 95% confidence interval: 0.69-0.92, P = 0.002). Both groups had similar median length of stay, though CUD(+) patients were more likely to have higher hospital cost compared to CUD(-) patients (median = 94574 dollars vs 86615 dollars, P < 0.001).

CONCLUSION

CUD(+) cancer patients with severe sepsis, who tended to be younger, black, males with higher rates of substance use and depression had paradoxically significantly lower odds of all-cause in-hospital mortality and respiratory failure. Future research should aim to better elucidate the underlying mechanisms for these observations.

Small Integrin binding Ligand N-linked Glycoproteins, prostate-specific antigen and time to prostate cancer diagnosis

BACKGROUND

Small Integrin Binding Ligand N-linked Glycoproteins (SIBLINGs1) were associated with cancer in cross-sectional studies. Whether SIBLINGs associate with preclinical disease is unknown.

METHODS

A retrospective longitudinal case control study was performed to determine the association of SIBLINGs and prostate-specific antigen (PSA) with preclinical disease. Paired serum samples from 109 cancer-free Baltimore Longitudinal Study on Aging participants were divided into those that were either most distal or proximal to diagnosis (cases) or censored (controls). Dentin sialophosphoprotein (DSPP), bone sialoprotein (BSP), osteopontin (OPN), and PSA were measured by immunoassay and dichotomized into low or high based on their respective cut-off values. Associations of time to diagnosis or death, modeled as disease-free survival (DFS) or overall survival (OS), were assessed using Kaplan Meier and Cox proportional hazard survival estimates on individual and aggregated biomarkers in distal or proximal sets separately. Models were adjusted for relevant covariates. A false discovery rate analysis assessed significance of hazard ratios (HRs) in sets.

RESULTS

Biomarkers/aggregates identified as true discoveries for DFS included DSPP + PSA, OPN + PSA, DSPP + BSP + PSA, DSPP + OPN + PSA, where unadjusted distal HRs ranged between 11 and 27 and after adjusting for age from 7 to 15, while proximal HRs ranged between 6 and 10 unadjusted and 5 to 12 after adjusting for age. For proximal OS, true discoveries included DSPP + BSP, DSPP + OPN, DSPP + BSP + OPN, and DSPP + OPN + PSA where unadjusted HRs ranged between 6 and 20 while age-adjusted HRs ranged between 5 and 12.

CONCLUSIONS

These observations support SIBLINGs as biomarkers that associate with DFS and OS in prediagnosis samples.

Clinicopathological characteristics and prognostic outcomes of pregnancy-associated colorectal cancer: A 24-year experience

BACKGROUND

Colorectal cancer (CRC) during pregnancy poses significant risks to both maternal and fetal health; however, this topic remains under researched globally.

AIM

To investigate the impacts of clinical features, pathology type, treatment strategies, and tumor stage on maternal and fetal outcomes in pregnant patients with pregnancy-associated CRC (pCRC).

METHODS

To address this research gap, we analyzed the clinical and pathological characteristics of pCRC by collecting and evaluating clinicopathological data from 43 patients treated at the National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences, between 1999 and 2023 using descriptive statistical methods.

RESULTS

Treatment for pCRC was initiated with surgery and/or chemotherapy. Among 43 patients, 37 underwent surgery, including 21 radical resections (5 prenatal and 16 postpartum resections) and 16 palliative surgeries. Chemotherapy (with regimens such as CapeOx or FOLFOX4) was administered to 37 patients. Six advanced-stage patients received chemotherapy alone. The gestational outcomes among the patients varied. Specifically, 5 patients who were diagnosed in early pregnancy chose abortion. Additionally, in mid-pregnancy, 3 patients underwent abortion, 1 required induced labor, and 2 underwent cesarean delivery with healthy neonates. Among the 3 late-pregnancy diagnoses, 1 patient underwent induced abortion, 1 delivered via cesarean section with a healthy fetus, and 1 underwent stillbirth management. The 5-year survival rate was 59.8%, with a rate of 100% for stage I/II patients, 75% for stage III patients, and 21.1% for stage IV patients.

CONCLUSION

Patients with poorly differentiated tumors exhibited worse outcomes than those with moderately and highly differentiated tumors. Early-stage diagnosis and timely treatment significantly improved maternal survival and fetal outcomes in pregnant patients with CRC. Advanced tumor stages and delayed diagnosis were observed to be associated with poorer maternal prognoses and may require interventions that compromise fetal survival. Fetal outcomes depend on the pathological stage of the mother’s cancer, the gestational age at diagnosis, and treatment strategies.

Clinical Sensitivity and Specificity of the PROSTest in an American Cohort

INTRODUCTION

Prostate cancer (PCa) is the most commonly diagnosed cancer in men in the United States, following skin cancer, with an incidence rate of 112.7 per 100,000 men per year. The need for a reliable, non-invasive diagnostic tool for early PCa detection (screening, biochemical residual disease) remains unmet due to the limitations of PSA testing, which often leads to overdiagnosis and overtreatment. The PROSTest is a novel, blood-based qPCR assay that assesses gene expression to diagnose PCa and predict patient outcomes to different treatments. This study aimed to validate the sensitivity and specificity of the PROSTest in a diverse cohort of US-based PCa patients compared to healthy controls.

MATERIALS AND METHODS

This prospective study included 143 PCa patients and 92 healthy controls. Blood samples were collected, and the PROSTest was conducted following RNA isolation and cDNA production, using a predefined 27-gene algorithm to provide a binary output. The assay's sensitivity and specificity were evaluated using receiver operating characteristic (ROC) analysis, with a 50% score cut-off distinguishing PCa from non-PCa patients. Analytical reproducibility was assessed with intra- and inter-assay comparisons of Ct values and PROSTest scores.

RESULTS

The PROSTest demonstrated a sensitivity of 94% (95% CI 89-98%) and a specificity of 88% (95% CI 80-94%) in distinguishing PCa patients from controls, with an area under the ROC curve (AUROC) of 0.97. The false positive rate among controls was 12%. Intra- and inter-assay reproducibility was confirmed with no significant differences in Ct values or PROSTest scores between operators or assays. PROSTest scores were significantly higher in PCa patients compared to controls and in those undergoing treatment versus untreated patients.

CONCLUSION

This validation study confirms the high sensitivity and specificity of the PROSTest in detecting PCa in a diverse USA cohort. The assay's robustness and reproducibility support its potential as a reliable diagnostic tool for PCa detection and monitoring. Further studies are warranted to evaluate its utility across broader populations and treatment settings.

Salpingectomy With Delayed Oophorectomy Versus Salpingo-Oophorectomy in BRCA1/2 Carriers: Three-Year Outcomes of a Prospective Preference Trial

OBJECTIVE

To compare menopause-related quality of life (QoL) after risk-reducing salpingectomy (RRS) versus risk-reducing salpingo-oophorectomy (RRSO) until 3 years of post-surgery.

DESIGN

A prospective study (TUBA study) with treatment allocation based on patients' preference. Data were collected pre-surgery and at 3 months, 1 and 3 years of post-surgery.

SETTING

Multicentre prospective preference trial in thirteen hospitals in the Netherlands.

POPULATION

BRCA1/2 pathogenic variant (PV) carriers aged 25-40 (BRCA1) or 25-45 (BRCA2), who were premenopausal, without a future child wish and without current (treatment for) malignancy.

METHODS

Treatment allocation was based on patients' preference: either RRS from the age of 25 years with delayed oophorectomy at the maximum age of 45 (BRCA1) or 50 (BRCA2), or RRSO between the ages of 35-40 (BRCA1) or 40-45 (BRCA2). After RRSO, hormone replacement therapy (HRT) was recommended, if not contraindicated. Primarily, menopause-related QoL as measured with the Greene Climacteric Scale (GCS) was compared between the RRS and RRSO without HRT group. Secondarily, GSC-scores of the RRS group were compared with the scores of the RRSO with HRT after surgery group. A higher GSC-score reflects more climacteric symptoms.

RESULTS

Until April 2023, 410 participants had undergone RRS and 160 RRSO. The BRCA1/BRCA2 proportions were 51.4%/48.6%. The mean age at surgery (SD) was 37.9 (3.5) years. Participants 3 years after RRSO without HRT had a 4.3 (95% CI 2.1-6.5; p < 0.001) point higher increase in GCS-score from baseline compared to those after RRS, while the difference was 7.9 (95% CI 5.9-9.8) and 8.5 (95% CI 6.5-10.5) points at 3 and 12 months, respectively. Among participants with HRT after surgery, the RRSO group had a 2.4 (95% CI 0.8-3.9; p = 0.002) point higher increase in GCS-score from baseline compared to the RRS group.

CONCLUSIONS

In this multicentre preference trial, menopause-related QoL was better after RRS than after RRSO, even with HRT after RRSO. Differences between arms were most pronounced until one-year post-surgery.

Polyethylene oxide-chitosan-doxorubicin/polycaprolactone-chitosan-curcumin pH-sensitive core/shell nanofibrous mats for the treatment of breast cancer: Fabrication, characterization and in vitro and in vivo evaluation

The main objective of this study was to fabricate a pH-sensitive drug carrier based on coaxial electrospun nanofibrous mats for concurrent local delivery of hydrophilic and hydrophobic anti-cancer drugs to improve the anti-tumor efficacy on breast cancer. Therefore, co-axial electrospinning technique was applied to prepare polyethylene oxide-chitosan/polycaprolactone-chitosan (PEO-CS/PCL-CS) pH-sensitive core-shell nanofibers. Doxorubicin hydrochloride (DOX, hydrophilic anti-cancer) and curcumin (CUR, hydrophobic anticancer) were loaded into core and shell sections of the fabricated pH-sensitive coaxial nanofibers, respectively. Their structure and morphology were analyzed via SEM, TEM, TGA, and FTIR techniques. The results of in vitro release analysis indicated that the release of DOX and CUR from the fabricated nanofibers was strongly depended on pH. The combined effects of the two drugs on MCF-7 cell inhibition, as measured by the MTT assay, revealed that the 1:5 ratio of DOX to CUR resulted in a CI of 0.00492, showing the strongest synergistic effect. The results of in-vivo studies indicated that the PEO-CS-DOX/PCL-CS-CUR pH-sensitive core-shell nanofibers possessed remarkable anti-tumor efficacy. As a result, PEO-CS-DOX/PCL-CS-CUR pH-sensitive core-shell nanofibrous mats with pH-responsive and sustainable and controllable manner could improve the local anti-tumor efficacy on breast cancer via inhibiting the side effects of free DOX and CUR drugs.

Prognostic value of the neutrophil‑to‑lymphocyte ratio in renal cell carcinoma: A systematic review and meta‑analysis

The neutrophil-to-lymphocyte ratio (NLR) not only indicates the inflammatory response within the tumor microenvironment but may also correlate with tumor biological behavior (such as aggressiveness). The present study aimed to systematically review and conduct a meta-analysis on the impact of the NLR on the prognosis of patients with renal cell carcinoma (RCC). To this aim, a comprehensive search of multiple relevant databases, including PubMed, Embase and the Cochrane Library, was conducted to identify literature related to NLR and RCC prognosis. Following rigorous literature screening and quality assessment, a systematic quantitative analysis was ultimately performed on several studies that met the inclusion criteria. The results indicated a significant association between elevated NLR levels and poor prognosis in patients with RCC, suggesting that high NLR levels may serve as an independent predictor of unfavorable outcomes. Therefore, the present study provides important evidence for clinical decision-making, further demonstrating that NLR can serve as an independent prognostic indicator for patients with RCC, aiding healthcare professionals in making more precise judgments in patient management and treatment strategy formulation.

2-Dodecyl-6-Methoxycyclohexa-2,5-Diene-1,4-Dione from Averrhoa carambola L. roots: Suppressing hepatocellular carcinoma progression through ROS accumulation and p53 pathway-mediated apoptosis

This study explores the anti-tumor effects of 2-dodecyl-6-methoxycyclohexa-2,5-diene-1,4-dione (DMDD), a compound derived from Averrhoa carambola L roots, on hepatocellular carcinoma (HCC) cells and a xenograft mouse model, focusing on its underlying mechanisms. Cell viability following DMDD treatment was assessed using the CCK-8 assay. Flow cytometry determined changes in cell cycle distribution and apoptosis rates, while migration and invasion capabilities were assessed using wound healing and transwell assays, respectively. Transcriptome sequencing (RNA-seq) was conducted to analyze differential gene expression and pathway enrichment. Z-VAD-FMK, a pan-caspase inhibitor, was used to confirm the apoptotic mechanism induced by DMDD. The expression levels of p53, Bax, Bcl-2, and cleaved caspase 3 were quantified via Western blot analysis. A xenograft mouse model was developed to assess the in vivo effects of DMDD on HCC. DMDD suppressed proliferation, migration, and invasion, and induced apoptosis in Huh7 and Hep3b cells. RNA-seq revealed significant enrichment of p53 and apoptosis signaling pathways among differentially expressed genes. DMDD downregulated Bcl-2 expression and upregulated p53, Bax and cleaved caspase 3. In addition, Z-VAD-FMK partially inhibited DMDD-induced apoptosis. DMDD also inhibited tumor growth in mice. DMDD effectively inhibited tumor growth in HCC cell lines and xenograft models, potentially through ROS elevation and p53-mediated activation of the intrinsic apoptotic pathway.

miR-338-3p Targets SIRT6 to Inhibit Liver Cancer Malignancy and Paclitaxel Resistance

For patients with liver cancer, a widespread and lethal tumor on a global scale, chemotherapy and immunotherapy are often the top choices. Paclitaxel, a widely administered chemotherapy drug, faces the dual issues of poor tumor response rates and the rapid onset of chemoresistance. This study delves into the functions of SIRT6 and miR-338-3p in malignancy and paclitaxel resistance of liver cancer cells. Bioinformatics and qRT-PCR were engaged to predict and examine expression profiles of SIRT6 and miR-338-3p in liver cancer tissues and cell lines. A paclitaxel-resistant cell line (MHCC97-PTX) was established for dissecting cellular responses to drug treatment. CCK-8 and colony formation tests measured cell vitality and proliferation, respectively. Flow cytometry assessed apoptotic cell death, and the paclitaxel IC50 values were derived for each group. We utilized online tools to predict miR-338-3p as an upstream regulator of SIRT6, and a dual-luciferase reporter assay verified their direct interaction. SIRT6 is abundantly expressed in liver cancer tissues and cells. SIRT6 knockdown decreased cell vitality and proliferation while promoting apoptosis and paclitaxel sensitivity. miR-338-3p, an upstream regulator of SIRT6 in liver cancer cells, binds to SIRT6 and downregulates its expression, modulating cell malignancy and drug resistance. The duo of miR-338-3p and SIRT6 can drive the aggressiveness and chemoresistance of liver cancer, emerging as hopeful candidates for biomarkers and therapeutic targets.

ERK2-mediated phosphorylation of ZEB1 at S322 enhances PD-L1 expression and EMT, leading to pancreatic cancer progression

BACKGROUND

Pancreatic cancer is the fourth leading cause of cancer-related deaths. Epithelial-mesenchymal transition (EMT) drives aggressive behaviour and unfavourable outcomes in this disease. The zinc finger E-box-binding homeobox 1 (ZEB1) transcription factor is pivotal in orchestrating EMT, promoting tumor cell mobility, metastasis, and immune evasion through phosphorylation events. However, the precise mechanisms underlying individual phosphorylation sites and their relationship with ZEB1's functions in vivo remain inadequately understood.

METHODS

We assessed EMT using various techniques, including reverse transcription-quantitative polymerase chain reaction (RT-qPCR), immunoblotting, microscopy, migration, and invasion assays. ZEB1 knockdown was achieved via short hairpin RNA (shRNA), while plasmid transfection facilitated the overexpression of ZEB1, extracellular signal-regulated kinase 1 (ERK1), and extracellular signal-regulated kinase 2 (ERK2). Co-immunoprecipitation and kinase assays were used to examine the interaction between ZEB1 and ERK1/2. PANC-1 and HPAC cells were transplanted in an orthotopic mouse model for in vivo analysis.

RESULTS

Sphingosylphosphorylcholine (SPC) induced EMT in PANC-1 and HPAC cells in a dose- and time-dependent manner through the phosphorylation and nuclear translocation of ZEB1. Notably, ERK2 interacted with ZEB1 and catalysed the phosphorylation of serine 322 (S322) within the ZEB1 molecule. Disrupting S322 phosphorylation hindered ZEB1's nuclear translocation, leading to reduced programmed death-ligand 1 (PD-L1) expression and suppressed migration and invasion of pancreatic cancer cells. Furthermore, in an orthotopic mouse model, implantation of S322 phosphorylation-deficient (shZEB1/S322A) pancreatic cancer cells suppressed tumour formation and metastasis. We developed a phosphoS322 detection antibody, which validated ZEB1 phosphorylation in pancreatic cancer cells and tissue samples from patients with pancreatic cancer.

CONCLUSION

SPC induces ZEB1 phosphorylation, with ERK2, rather than ERK1, targeting the S322 site. Inhibiting S322 phosphorylation mitigates EMT, PD-L1 expression, and progression of pancreatic cancer. The phosphoS322 detection antibody might be a valuable tool for predicting pancreatic cancer prognosis. These findings implicate ERK2 as a potential therapeutic target for pancreatic cancer and highlight phosphoZEB1 as a valuable prognostic marker.

TPX2 promotes papillary renal cell carcinoma progression by forming a ceRNA with LINC00894

PURPOSE

Papillary renal cell carcinoma (pRCC), particularly type 2, is associated with a poor prognosis. This study aimed to identify molecular mechanisms underlying pRCC progression and explore potential therapeutic targets to improve patient outcomes.

METHODS

TPX2 expression was analyzed in tumor samples from patients with type 2 pRCC. In vitro experiments were conducted to assess the effects of TPX2 and LINC00894 knockdown and overexpression on the proliferation and migration of Caki-2 and ACHN cells. Immunohistochemical analysis of tissue microarrays was performed to evaluate the associations between TPX2 expression and clinicopathological characteristics in type 2 pRCC patients.

RESULTS

Elevated TPX2 expression was significantly associated with a worse prognosis in type 2 pRCC patients and served as an independent risk factor for overall survival. Knockdown of TPX2 in Caki-2 and ACHN cells significantly reduced cell proliferation and migration. Additionally, LINC00894 was highly expressed in type 2 pRCC and correlated with poor prognosis. Mechanistically, miR-660-5p targeted the TPX2 3' UTR, promoting TPX2 degradation, while LINC00894 competitively bound to miR-660-5p, protecting TPX2 from miRNA-mediated degradation and exerting a pro-oncogenic effect. Immunohistochemical analysis revealed significant correlations between TPX2 expression and clinicopathological features, including tumor thrombus volume, tumor diameter, pathological TNM stage, and Fuhrman grade.

CONCLUSION

This study underscores the critical role of TPX2 in type 2 pRCC progression and highlights its potential as a prognostic biomarker and therapeutic target. The TPX2/LINC00894/miR-660-5p regulatory axis provides novel insights into the molecular mechanisms driving pRCC and offers a promising avenue for improving patient prognosis.

Preoperative myosteatosis as a novel prognostic biomarker after anatomical lung resection for non-small cell lung cancer

PURPOSE

Myosteatosis, or excessive deposition of adipose tissue within skeletal muscle, has been widely used to explain an impaired muscle quality. This study aimed to investigate the association between preoperative myosteatosis and surgical outcomes in patients with non-small-cell lung cancer (NSCLC).

METHODS

We retrospectively examined 492 patients who underwent anatomical lung resection for stages I-III NSCLC between January 2014 and December 2022. The patients were divided into low- and high-paraspinal muscle density (MD) groups based on the lowest quartile cutoff value of MD on contrast-enhanced computed tomography, with the low-MD group defined as having myosteatosis.

RESULTS

The five-year overall survival (OS) and recurrence-free survival (RFS) rates were significantly lower in the myosteatosis group than in the control group (59.1% vs. 86.8%, P < 0.001; 52.0% vs. 72.6%, P < 0.001, respectively). A multivariate analysis identified myosteatosis as an independent predictor of OS (hazard ratio [HR], 2.809; 95% confidence interval [CI], 1.781-4.430; P < 0.001) and RFS (HR, 1.894; 95%CI, 1.340-2.678; P < 0.001). There was a significant correlation between myosteatosis and prolonged air leak postoperatively (P = 0.039).

CONCLUSION

Perioperative nutritional and exercise interventions facilitate changes in body composition, which may improve the outcomes in patients with lung cancer undergoing anatomical resection.

Pre-treatment tumour PET metrics and clinical outcomes of anal cancer in patients living with and without HIV

BACKGROUND/PURPOSE

To investigate if pre-treatment tumour positron-emission tomography (PET) metrics' prognostic efficacy changes with HIV or viral load (VL) in anal squamous cell carcinoma (ASCC).

MATERIALS AND METHODS

Consecutive patients treated with definitive radiation therapy (RT) for non-metastatic ASCC from 2005 to 2021 at one institution were retrospectively identified. Patient demographic and clinical data, including HIV status and pre-treatment VL, were tabulated. Pre-treatment PET metrics were calculated with semi-automatic gradient-based segmentation algorithms. Cox-proportional-hazard and Kaplan-Meier modelling were used to investigate tumour PET metrics and outcomes: overall survival (OS), progression-free survival (PFS), and locoregional control (LRC).

RESULTS

A total of 175 patients were included: 110 HIV-negative and 65 patients living with HIV (PLWH). Nineteen PLWH had detectable pre-treatment VL. Median follow-up was 58 months (interquartile range [IQR]: 28-99), with 28 locoregional failures and 31 deaths. Five-year LRC, PFS, and OS was 84%, 73%, and 86%, respectively. There was no significant difference in LRC, PFS, or OS between HIV-negative patients and PLWH. 156 patients had available pre-treatment PET scans. Metabolic tumour volume and total lesion glycolysis were significantly associated with LRC and PFS on multivariate Cox analysis for the entire cohort (p ≤ 0.02), and HIV-negative patients on Cox sub-group analysis (p ≤ 0.01). No association between PET metrics and outcomes was seen for PLWH.

INTERPRETATION

Outcomes were comparable between HIV-negative patients and PLWH. Pre-treatment PET metrics were validated as significantly predicting outcomes for the entire cohort and HIV-negative patients, not PLWH. This may be from small numbers of PLWH patients, or non-specific uptake in patients with uncontrolled HIV reducing PET's prognostic efficacy.

Navigating second-line therapy in metastatic renal cell carcinoma: a comparative analysis of immune checkpoint inhibitors and tyrosine kinase inhibitors: a study of Turkish Oncology Group Kidney Cancer Consortium

Background

Despite progress in treatment, many metastatic renal cell carcinoma (mRCC) patients still experience progression after first-line tyrosine kinase inhibitor (TKI), necessitating effective second-line options. While guidelines endorse combination therapies, accessibility limitations often restrict therapy to TKI monotherapy.

Objectives

Existing decision-making relies on limited evidence, lacking direct comparisons between the leading second-line options (cabozantinib and nivolumab) which surpass everolimus in advanced mRCC. To address this gap, this study compares the efficacy of TKI versus nivolumab in second line while investigating factors influencing outcomes.

Design

This was a retrospective cohort study.

Methods

Turkish Oncology Group Kidney Cancer Consortium includes more than 1000 mRCC patients from 13 centers in Türkiye. It has the largest national data. We extracted 214 patients treated with a TKI in the first line and nivolumab or TKI in the second line.

Results

The median overall survival (OS) and time to treatment failure (TTF) were similar in the TKI-TKI and TKI-immune checkpoint inhibitor (ICI; 41.1 and 44.8 months, p = 0.446 for OS; 27.4 and 29.8 months, p = 0.857 for TTF). The presence of previous nephrectomy for TTF made a significant difference in univariable and multivariable analysis. Bone metastases negatively affected TTF in both univariable and multivariable analyses. In the neutrophil-to-lymphocyte ratio (NLR)-high group, OS and TTF were longer in patients treated with TKI-ICI than in the TKI-TKI. In multivariable analysis, NLR was an independent prognostic factor for OS and TTF to select ICI in the second-line.

Conclusion

Our analysis revealed no significant difference in OS between patients receiving ICIs or TKIs as second-line therapy. In the subgroup of patients with elevated NLR, ICI therapy was found to cause no improvement in OS. This finding suggests the potential utility of NLR as a biomarker to guide targeted selection of ICI therapy among patients progressing after first-line TKIs. Furthermore, our study identified other noteworthy prognostic factors influencing outcomes, including the presence of bone or liver metastases, Eastern Cooperative Oncology Group performance status, and International Metastatic Renal Cell Carcinoma Database Consortium risk score.

Development and validation of a novel model for patients with soft tissue sarcoma who received neoadjuvant chemotherapy

Although surgical resection combined with radiotherapy is still the preferred treatment for soft tissue sarcoma, neoadjuvant chemotherapy is becoming more popular. The goal of this research is to get a large, multicenter retrospective analysis to build a practical and validated method to predict overall survival in patients. This study was a retrospective study of 902 soft tissue sarcoma patients from the Surveillance, Epidemiology, and End Results database who received neoadjuvant chemotherapy. We used the Cox multivariate model to build a nomogram for predicting overall survival and converted it into a web-based nomogram. To identify and calibrate the model, bootstrap resampling was used to draw receiver operating characteristic curves and calibration curves, as well as to test the clinical applicability of the model by plotting decision curves. A total of 634 patients were included in the training cohort, while the remaining 268 patients were included in the validation cohort. Overall survival was significantly influenced by disease stage, age, tumor size, grade, and radiation, and nomograms were created to predict overall survival. The area under the curve for predicting overall survival at 1, 3, and 5 years in the training cohort was 0.797, 0.751, and 0.739, respectively; the area under the curve for the validation cohort was 0.726, 0.747, and 0.698, respectively. The calibration curves showed that the model performs well in terms of calibration (prediction accuracy). In addition, the decision curve analysis demonstrates the good clinical application of the model, allowing for a greater net clinical benefit. For soft tissue sarcoma patients who have received neoadjuvant chemotherapy, we have developed the first novel tool to accurately predict overall survival. This tool improves clinicians' ability to assess patient prognosis, enhances prognosis-based treatment decisions, and can be used as a guide for clinicians to consult with patients.

Pan-cancer analysis and validation show GTF2E2's diagnostic, prognostic, and immunological roles in regulating ferroptosis in endometrial cancer

BACKGROUND

Transcription initiation factor IIE subunit beta (GTF2E2) is a crucial component of the RNA polymerase II transcription initiation complex. There is a lack of more detailed research on the biological function of GTF2E2 in pan-cancer.

METHODS

We conducted a comprehensive pan-cancer analysis using data from The Cancer Genome Atlas (TCGA) and Genotype-Tissue Expression (GTEx) project. Employing a multi-pronged approach with tools including R, Cytoscape, TISIDB, cBioPortal, STRING, GSCALite, and CancerSEA, we investigated GTF2E2's expression patterns, prognostic value, mutational landscape, functional enrichment, and immunological associations across 33 cancer types. Besides, we further validated the bioinformatic results through in vitro experiments in Uterine corpus endometrial carcinoma (UCEC), including western blotting (WB), cell proliferation assays and transwell. DCFH-DA, C11-BODIPY 581/591 and FeRhoNox-1 probes were performed to identify ferroptosis levels in vitro.

RESULTS

GTF2E2 expression was significantly elevated in most cancers compared to normal tissues, with notable diagnostic potential (AUC > 0.7) in 20 cancer types. GTF2E2 expression varied across molecular and immune subtypes and correlated with tumor stage and patient age in several cancers. Functional enrichment analyses highlighted GTF2E2's involvement in key cancer-related and immunological pathways. Notably, GTF2E2 promoted UCEC progression in vitro, and knockdown of GTF2E2 significantly inhibited the proliferation, migration and invasion of UCEC cells. Compared with the control group, GPX4 expression was down-regulated and ACSL4 expression was up-regulated in the GTF2E2-knockdown group. Knockdown of GTF2E2 also increased the intracellular levels of Fe2+, lipid peroxides (LPOs) and reactive oxygen species (ROS).

CONCLUSIONS

Our findings underscore GTF2E2's multifaceted roles in cancer biology, highlighting its potential as a diagnostic biomarker, prognostic indicator, and immunotherapeutic target across various malignancies. This investigation has the potential to contribute significantly to a deeper understanding of the substantial involvement of GTF2E2 in human malignancies, particularly UCEC.

Multifaceted roles of melatonin in oncology: an insight into its therapeutic potential in cancer management

Cancer remains the leading cause of death worldwide. The treatment of cancer has become increasing complex. Current treatment options for cancer include surgical resection, chemotherapy, radiotherapy, nanomedicine, and immunotherapy. Recent experimental and clinical studies have provided substantial evidence supporting the potential use of melatonin as a preventive and therapeutic agent in oncology. Melatonin (N-acetyl-5-methoxy-tryptamine), a pleiotropic and multitasking molecule, is secreted from the pineal gland during the night under normal light-dark conditions. Beyond its role in circadian regulation, melatonin exhibits antioxidant, anti-aging, immunomodulatory, and anti-cancer properties. Melatonin exerts significant apoptotic, angiogenic, oncostatic, and anti-proliferative effects on a variety of cancer cells. This review discusses the influence of melatonin on cancer cells through mechanisms involving cell cycle regulation, stimulation of apoptosis, autophagy induction, epigenetic modification, and transcriptional regulation.

Safety profile of sikamat virus and its oncolytic potential in leukemic cells and cancer stem cells

Leukaemia remains a global health concern. The oncotherapy resistance of leukaemia might be due to the existence of cancer stem cell populations. This study investigated the therapeutic potential of Sikamat virus (PRV7S), a Pteropine orthoreovirus, as an oncolytic virus against acute myeloid leukaemia (AML) and chronic myeloid leukaemia (CML). Using AML and CML cell lines (THP-1 and K562), as well as an AML-M5-derived cancer stem cell (CSC) model, PRV7S was shown to infect these leukaemic cells, replicate within them, and reduce their viability. PRV7S-induced cell death was associated with caspase-mediated apoptosis without significant cell cycle arrest. Transcriptomic and proteomic analyses revealed that PRV7S infection altered several cell death pathways, including apoptosis and necroptosis, highlighting its complex cell death mechanisms. PRV7S replicated efficiently in infected cells, though it did not cause persistent infection. An in vivo safety evaluation in immunocompetent mice demonstrated that PRV7S was well-tolerated, showing no adverse effects on survival, body weight, or histopathology, and no evidence of viral persistence. These findings suggest PRV7S as a promising oncolytic candidate for myeloid leukaemia, with potential efficacy against CSCs and a favourable safety profile. In conclusion, the study provides new insights into the cellular pathways involved in PRV7S-mediated oncolysis and supports further exploration of PRV7S's potential against resistant leukaemic and solid tumours.

Solitary recurrence of renal cell carcinoma in the ureter nearly two decades after radical nephrectomy

We report a man in his late 60s who presents with gross haematuria. He had a history of radical nephrectomy for renal clear cell cancer almost two decades ago. The CT showed an enhancing lesion in the distal ureteric stump, possibly urothelial carcinoma (UC). Ureterectomy and bladder cuff excision were done. Surprisingly, the biopsy revealed intraluminal renal clear cell carcinoma (RCC). The postoperative course was uneventful. The patient is free from disease at a 2 year follow-up. It is crucial to consider recurrent RCC in such a clinical scenario. This case also highlights the importance of prolonged surveillance for localised RCC (postsurgery) to detect late recurrence. Resection of such recurrence with curative intent confers good outcomes.

Effect of a 12-week exercise program on phase angle in women with breast cancer

PURPOSE

The aims of this study were to analyze the effects of a 12-week exercise intervention on bioelectrical impedance analysis-derived phase angle (PhA), resistance (R), and reactance (Xc) in breast cancer survivors (BCS) and analyze the relationship between changes in bioelectrical impedance variables and changes in functional capacity and muscular strength.

METHODS

This was a prospective cohort study. Potentially eligible patients were recruited from the Medical Oncology Unit of the hospital. Female BCS older than 18 years were offered to participate in the study if they had previously undergone surgery for their primary tumor and there was no evidence of recurrence at the time of recruitment. A 12-week exercise program including resistance and endurance training was performed, including two weekly sessions led by a physical therapist. Measurements were performed at baseline and after 12 weeks, including PhA and function-related outcomes. The relationship between changes in PhA and function-related outcomes was assessed using the Pearson r correlation coefficient.

RESULTS

Sixty-seven BCS women were included in the analysis. A significant increase was found in PhA and functional outcomes after the intervention, as well as a significant decrease in R. Bivariate correlations showed a significant positive correlation between PhA and functional tests (Hand grip, r = 0.37 [p = 0.002], 30-Sit to Stand, r = 0.39 [0.002], respectively).

CONCLUSION

A 12-week concurrent exercise program may be effective to improve PhA and R. Additionally, there appears to be a correlation between PhA and Xc with functional capacity outcomes. Finally, baseline PhA, Xc, and R values explained part of the 30-STS and hand grip tests variance at 12 weeks, which could suggest its importance in the prognosis.

Design and synthesis of novel styrylquinolinium derivatives for the treatment of breast Cancer: Targeting the c-Myc G-quadruplex

Inhibiting c-Myc gene expression by targeting the c-Myc G-quadruplex (G4) represents an effective strategy for breast cancer treatment. In order to find ligands that can specifically target the c-Myc G4, we utilized styrylquinolinium as the core element to anchor G4, and proposed three guiding principles for the design and synthesis of G4 ligands. Finally, compound W11 was identified as the compound skeleton which has the potential to target c-Myc G4. On this basis, compound X3 with higher c-Myc G4 selectivity was developed. Both W11 and X3 demonstrate significant inhibitory effects on breast cancer. Subsequently, we used molecular docking and molecular dynamics simulation to analyze the relationship between the targeting ability and chemical structure of W11 derivatives, and proposed a detailed structure-activity relationship model. Additionally, we found that the free energy landscape (FEL) of ligands with high selectivity and affinity for G4 is "centralized and singular" during this process. Cell experiments and MCF-7 tumor xenograft experiments demonstrated that W11 inhibited the proliferation and metastasis of breast cancer cells by downregulating the transcription and translation of the c-Myc gene. Moreover W11 significantly inhibited tumor tissue growth in vivo without causing obvious damage to major organs.

Effectiveness of using an online instructional video for preventing infections among Thai patients with cancer: A quasi-experimental study

Background

Patients with cancer are more likely to develop infections from several factors, and an infectious complication is the leading cause of death in this population. Therefore, nurses should provide educational media to these patients for infection prevention.

Objective

This study aimed to examine the effectiveness of using an online instructional video to prevent infections among patients with cancer in Thailand.

Methods

A quasi-experimental design was conducted from May 2020 to March 2021 at a cancer hospital in northeast Thailand. The participants consisted of 54 patients with cancer (27 each in the experimental and control group). The experimental group participants received four weeks of online video instruction at home, while the control group received the usual education from nurses. The data collection instruments included a demographic data questionnaire, a knowledge test, an infection prevention practice questionnaire, and a video media satisfaction questionnaire. Statistical analyses included descriptive statistics, chi-square test, Fisher's exact test, paired t -test, and independent t -test.

Results

After receiving the online instruction video, the experimental group had a significantly higher score for infection prevention knowledge, increasing from 17.52 to 20.93 (t = -6.575, p <0.001), and infection prevention practice, rising from 52.07 to 61.33 (t = -3.954, p = 0.001). The control group had no significant increase in the knowledge score (17.04 to 18.04) (t = -1.328, p = 0.100) or practice score (53.41 to 54.44) (t = -0.797, p = 0.217). The experimental group showed a significantly higher mean knowledge score (t = 4.473, p <0.001, large effect size with a Cohen's d of 1.22) and practice score (t = 3.121, p = 0.002, large effect size with a Cohen's d of 0.85) during post-intervention than the control group.

Conclusion

The findings support the use of online video as instructional media to enhance knowledge and practices regarding infection prevention among patients with cancer. This online video should be implemented for nurses and healthcare providers to promote knowledge and practices in the prevention of infections among patients with cancer in other hospitals.

Trial Registry Number

Thai Clinical Trials Registry (TCTR20241030009).

Study protocol for a randomized trial comparing cryobiopsy and conventional biopsy for peripheral pulmonary lesions

BACKGROUND

The introduction of radial endobronchial ultrasound (R-EBUS) and navigation has improved the diagnostic yield of bronchoscopy for peripheral pulmonary lesions (PPLs). Cryobiopsy could further raise the yield, and the advent of single-use cryoprobes has shown promise in enhancing yields even when used alone. This multicenter randomized controlled trial aims to compare the diagnostic performance of cryobiopsy with that of conventional biopsy during bronchoscopy for PPLs.

METHODS

The study will enroll 660 patients with PPLs ≤30 mm. Eligible patients will undergo bronchoscopy with a thin bronchoscope and R-EBUS. If the target lesion is considered reachable based on R-EBUS findings, patients will be allocated equally to the conventional biopsy and cryobiopsy groups. Conventional biopsy will be performed using forceps and/or aspiration needles, whereas cryobiopsy will employ a single-use cryoprobe. The primary endpoint is to compare the histology-based diagnostic yield between the two groups. A subgroup analysis will also be conducted based on predetermined factors to explore the populations in which cryobiopsy is likely to be effective. The secondary endpoints are to evaluate differences in diagnostic value and safety characteristics between the two groups.

DISCUSSION

This will be the first study to evaluate the efficacy of cryobiopsy in diagnostic bronchoscopy for PPLs. The results of this study directly comparing cryobiopsy with conventional biopsy will elucidate differences in their diagnostic performance.

ETHICS AND DISSEMINATION

The National Cancer Center Institutional Review Board approved this study (No. 2022-123, approval date: October 24, 2022).

TRIAL REGISTRATION

The University Hospital Medical Information Network Clinical Trials Registry (UMIN000049329).

Berberine inhibits metastasis of ovarian cancer by blocking lipid metabolism, alleviating aging of adipose tissue and increasing tumor infiltrating immune cells

Extensive peritoneal metastasis and malignant ascites continue to pose substantial challenges in achieving favorable treatment outcomes for ovarian cancer. Berberine (BBR), an active component of numerous traditional Chinese herbs, has demonstrated potent anti - tumor effects across various malignancies, including ovarian cancer. In this study, we comprehensively evaluated the impact of BBR on the growth and metastasis of ovarian cancer both in vitro and in vivo. RNA - sequencing was employed to elucidate the underlying mechanisms. Specifically, we investigated lipid metabolism and mitochondrial function in ovarian cancer cells and mice, comparing BBR - treated and untreated groups. Additionally, CIBERSORT analysis and immunohistochemical (IHC) staining were utilized to confirm BBR's ability to enhance the infiltration of tumor-infiltrating immune cells into adipose tissue and improve the inflammatory tumor microenvironment. Our findings indicate that BBR significantly inhibits the growth and metastasis of ovarian cancer in vitro and in vivo. The effects can be attributed to two key processes. Firstly, BBR suppresses the lipid metabolism by downregulating lipid uptake related receptor CD36, lipid metabolic enzyme and mitochondrial function. Secondly, BBR alleviates the aging of adipose tissue and adipose derived stem cells (ADSCs), thereby decreasing the secretion of senescence-associated secretory phenotype (SASP). These ultimately lead to the increasing the improvement of tumor infiltrating immune cells, such as CD4⁺ helper T cells (CD3⁺CD4⁺) and cytotoxic T lymphocytes (CD3⁺CD8⁺), and inflammation in ovarian cancer tissue. Collectively, these findings suggested a potential therapeutic effect of BBR in the treatment of advanced ovarian cancer, particularly cases complicated by peritoneal metastasis and malignant ascites.

Recent Advances in Enzyme-Activated Dual-Locked Probes for Biological Applications

Enzymes catalyze reactions involved in diverse physiological, pathological, and pharmacological processes. By employing the optical probe, fluorescence imaging enables non-invasive, real-time detection and assessment of disease states based on enzymatic activity. However, most enzyme-activated probes are single-locked probes that respond to a single biomarker. In comparison to single-locked probes, enzyme-activated dual-locked probes can effectively minimize the occurrence of false-positive signals, circumvent the problem of low specificity associated with biologically active substances, and facilitate precise imaging. This review systematically summarizes the design and application of dual-locked probes in disease diagnosis, with the aim of providing inspiration for researchers in the field.

Lysine-specific demethylase 1 controls key OSCC preneoplasia inducer STAT3 through CDK7 phosphorylation during oncogenic progression and immunosuppression

Oral squamous cell carcinoma (OSCC) progresses from preneoplastic precursors via genetic and epigenetic alterations. Previous studies have focused on the treatment of terminally developed OSCC. However, the role of epigenetic regulators as therapeutic targets during the transition from preneoplastic precursors to OSCC has not been well studied. Our study identified lysine-specific demethylase 1 (LSD1) as a crucial promoter of OSCC, demonstrating that its knockout or pharmacological inhibition in mice reversed OSCC preneoplasia. LSD1 inhibition by SP2509 disrupted cell cycle, reduced immunosuppression, and enhanced CD4+ and CD8+ T-cell infiltration. In a feline model of spontaneous OSCC, a clinical LSD1 inhibitor (Seclidemstat or SP2577) was found to be safe and effectively inhibit the STAT3 network. Mechanistic studies revealed that LSD1 drives OSCC progression through STAT3 signaling, which is regulated by phosphorylation of the cell cycle mediator CDK7 and immunosuppressive CTLA4. Notably, LSD1 inhibition reduced the phosphorylation of CDK7 at Tyr170 and eIF4B at Ser422, offering insights into a novel mechanism by which LSD1 regulates the preneoplastic-to-OSCC transition. This study provides a deeper understanding of OSCC progression and highlights LSD1 as a potential therapeutic target for controlling OSCC progression from preneoplastic lesions.

A higher preoperative cachexia index can result in the sufficient administration of S-1 adjuvant chemotherapy and lead to a good prognosis for elderly patients with stage II/III gastric cancer

PURPOSE

This study aimed to clarify the significance of the relative dose intensity (RDI) of S-1 adjuvant chemotherapy (ACT) after gastrectomy in elderly patients with stage II/III gastric cancer (GC) and to determine whether the cachexia index (CXI) correlates with RDI.

METHODS

We enrolled 76 patients with stage II/III GC, aged > 70 years. The overall survival (OS) and disease-specific survival (DSS) of participants in the surgery alone, S-1 ACT completion (RDI ≥ 58%), and S-1 ACT non-completion (RDI < 58%) groups were compared. In addition, the clinicopathological determinants of RDI were examined.

RESULTS

The S-1 ACT completion group had better OS and DSS, while the prognoses of patients in the surgery alone and S-1 ACT non-completion groups did not differ significantly. S-1 ACT non-completion or surgery alone was identified as an independent poor prognostic factor for OS and DSS. Furthermore, a multivariate analysis revealed that a high preoperative CXI (≥ 75.5 for males and ≥ 79.4 for females) was an independent predictor of success in achieving an RDI ≥ 58%.

CONCLUSIONS

A higher preoperative CXI can result in a higher RDI and improve the prognosis of elderly patients with stage II/III GC who underwent S-1 ACT.

RNA biosensors for detection of pancreatic cancer

Pancreatic cancer is recognized as one of the most lethal types of cancer globally, characterized by a high mortality rate and a bleak prognosis, which greatly contributes to cancer-related deaths. Forecasts suggest that by 2030, pancreatic cancer will exceed other cancer types in prevalence. The disease presents considerable difficulties owing to the lack of prominent symptoms in its early stages, restricted options for early detection, rapid progression, and unfavorable outcomes. Presently, traditional methods for diagnosing pancreatic cancer primarily rely on imaging techniques. However, these methods often entail significant costs, require considerable time, and necessitate specialized skills for both operating the equipment and interpreting the resulting images. To overcome these obstacles, the use of biosensors has been proposed as a potentially valuable tool for the early detection of pancreatic cancer. MicroRNAs (miRs), a type of small non-coding RNA molecules, have emerged as highly sensitive molecular diagnostic tools that have the potential to function as precise indicators for a range of diseases, including cancer. Biosensors have been suggested as a potential solution for tackling these challenges, offering a promising approach for the early detection of pancreatic cancer. Small non-coding RNA molecules known as MicroRNAs (miRs) have become recognized as extremely sensitive molecular diagnostic tools and can act as precise biomarkers for different diseases, such as cancer. Moreover, this manuscript presents a thorough summary of the latest innovations in nano-biosensors that have been specifically developed for the identification of non-coding RNAs related to pancreatic cancer.

Trends in nanomedicine for colorectal cancer treatment: Bibliometric and visualization analysis (2010-2024)

BACKGROUND

Recently, numerous studies have reported the application of nanomedicines in colorectal cancer treatment. However, no systematic bibliometric analysis has been conducted to examine the potential and mechanisms of action of nanomedicine in this context. Such an analysis may provide a comprehensive overview of the current research landscape, identify emerging trends, and highlight key areas for future investigation.

AIM

To describe the current global research landscape on the application of nanomedicine in colorectal cancer treatment.

METHODS

The Web of Science Core Collection database was searched for literature published from January 1, 2010, to August 7, 2024, focusing on the application of nanomedicine in colorectal cancer treatment. Bibliometric analysis and visualization mapping of countries, institutions, authors, keywords, references of the relevant research literature were conducted using CiteSpace (6.2R6), VOSviewer (1.6.20), and bibliometrix (based on R 4.3.2).

RESULTS

A total of 3598 articles were included, with a rapid increase in publication volume starting from 2010. China published the most papers on this topic, followed by the United States and India. The United States emerged as the central country in this field, and the Egyptian Knowledge Bank and Chinese Academy of Sciences were the institutions with the highest number of publications. The Chinese Academy of Sciences exhibited the highest centrality. The most prolific author was Zhang Y, whereas Siegel RL was the most cited author, and Li Y had the highest H-index. The International Journal of Nanomedicine had the most publications and Biomaterials received the most citations. Keyword co-occurrence analysis identified 11837 keywords grouped into 13 clusters with 15 high-frequency highlighted keywords. The top three keyword clusters were "0 colorectal cancer", "1 drug delivery", and "2 delivery", with the top three keywords being "nanoparticles", "colorectal cancer", and "drug delivery".

CONCLUSION

Research on nanomedicine for colorectal cancer has surged since 2010, focusing on "nanoparticles" and "drug delivery". Future studies should investigate nanomaterial stability and target-specific drug release.

Exosomal biomarkers: A novel frontier in the diagnosis of gastrointestinal cancers

Gastrointestinal (GI) cancers, which predominantly manifest in the stomach, colorectum, liver, esophagus, and pancreas, accounting for approximately 35% of global cancer-related mortality. The advent of liquid biopsy has introduced a pivotal diagnostic modality for the early identification of premalignant GI lesions and incipient cancers. This non-invasive technique not only facilitates prompt therapeutic intervention, but also serves as a critical adjunct in prognosticating the likelihood of tumor recurrence. The wealth of circulating exosomes present in body fluids is often enriched with proteins, lipids, microRNAs, and other RNAs derived from tumor cells. These specific cargo components are reflective of processes involved in GI tumorigenesis, tumor progression, and response to treatment. As such, they represent a group of promising biomarkers for aiding in the diagnosis of GI cancer. In this review, we delivered an exhaustive overview of the composition of exosomes and the pathways for cargo sorting within these vesicles. We laid out some of the clinical evidence that supported the utilization of exosomes as diagnostic biomarkers for GI cancers and discussed their potential for clinical application. Furthermore, we addressed the challenges encountered when harnessing exosomes as diagnostic and predictive instruments in the realm of GI cancers.

Boosting Skin Cancer Classification: A Multi-Scale Attention and Ensemble Approach with Vision Transformers

Skin cancer is a significant global health concern, with melanoma being the most dangerous form, responsible for the majority of skin cancer-related deaths. Early detection of skin cancer is critical, as it can drastically improve survival rates. While deep learning models have achieved impressive results in skin cancer classification, there remain challenges in accurately distinguishing between benign and malignant lesions. In this study, we introduce a novel multi-scale attention-based performance booster inspired by the Vision Transformer (ViT) architecture, which enhances the accuracy of both ViT and convolutional neural network (CNN) models. By leveraging attention maps to identify discriminative regions within skin lesion images, our method improves the models' focus on diagnostically relevant areas. Additionally, we employ ensemble learning techniques to combine the outputs of several deep learning models using majority voting. Our skin cancer classifier, consisting of ViT and EfficientNet models, achieved a classification accuracy of 95.05% on the ISIC2018 dataset, outperforming individual models. The results demonstrate the effectiveness of integrating attention-based multi-scale learning and ensemble methods in skin cancer classification.

Practical microenvironment classification in diffuse large B cell lymphoma using digital pathology

Diffuse large B cell lymphoma (DLBCL) is a heterogeneous B cell neoplasm with variable clinical outcomes influenced by both tumor-derived and lymphoma microenvironment (LME) alterations. A recent transcriptomic study identifies four DLBCL subtypes based on LME characteristics: germinal center (GC)-like, mesenchymal (MS), inflammatory (IN), and depleted (DP). However, integrating this classification into clinical practice remains challenging. Here, we utilize deconvolution methods to assess microenvironment component abundance, establishing an LME classification of DLBCL using immunohistochemistry markers and digital pathology based on CD3, CD8, CD68, PD-L1, and collagen. This staining-based algorithm demonstrates over 80% concordance with transcriptome-based classification. Single-cell sequencing confirms that the immune microenvironments distinguished by this algorithm align with transcriptomic profiles. Significant disparities in overall and progression-free survival are observed among LME subtypes following rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) or R-CHOP with targeted agents (R-CHOP-X) immunochemotherapy. LME subtypes differed from distinct immune escape mechanisms, highlighting specific immunotherapeutic targets and supporting application of this classification in future precision medicine trials.

Precision oncology and genetic ancestry: The science behind population-based cancer disparities

Precision oncology has transformed cancer care but has barely benefited patients of diverse ancestry. Historically, self-reported race/ethnicity has served as a surrogate for biological differences, but genetic ancestry provides a more precise framework for understanding genetic drivers of cancer disparities, including associations between ancestry and tumor subtypes, and genetic variants affecting drug metabolism and treatment response. To improve precision oncology for all patients and reduce cancer disparities, we propose expanding ancestry-inclusive genomic data, reevaluating disease-associated variants within ancestrally diverse cohorts, and standardizing data-sharing practices.

A novel peptide RR-171 derived from human umbilical cord serum induces apoptosis and pyroptosis in pancreatic cancer cells

Human umbilical cord serum is full of molecules that play vital roles in foetal development. This study aimed to explore the effects of RR-171, a novel peptide derived from umbilical cord serum, on pancreatic cancer cells and to elucidate its mechanisms. The anti-pancreatic cancer properties of RR-171 were detected by a cell counting kit-8, colony formation, flow cytometry, LDH release and EdU incorporation assays. RNA sequencing and gene enrichment analysis were applied to identify the differentially expressed genes and enriched pathways. Western blotting analysis was used to detect the expression of proteins. A subcutaneous xenograft model was used to examine the effect of RR-171 on pancreatic cancer cells in vivo. The results demonstrated that RR-171 inhibited the viability, proliferation and colony formation of pancreatic cancer cells in a dose-dependent manner. Gene enrichment analysis revealed that RR-171 inhibits the Wnt signaling pathway. Moreover, RR-171 significantly induced apoptosis and pyroptosis in pancreatic cancer cells in a dose-dependent manner. Z-VAD-FMK partly reversed the proapoptotic effect of RR-171, and VX-765 partly reversed the pro-pyroptotic effect of RR-171. Finally, RR-171 inhibited the growth of pancreatic cancer cells in a subcutaneous xenograft mice model and suppressed the expression of Ki-67 and PCNA in tumors. In conclusion, RR-171 induces apoptosis and pyroptosis through multiple pathways and inhibits pancreatic cancer growth, suggesting that RR-171 might be a potential agent for the treatment of pancreatic cancer.

Helminth-induced immune modulation in colorectal cancer: exploring therapeutic applications

Colorectal cancer is one of the most lethal tumors, posing a financial and healthcare burden. This study investigates how helminths and pre-existing diseases such as colitis, obesity, diabetes, and gut microbiota issues influence colon cancer development and prognosis. The immune system's protective immunosuppressive response to helminth invasion minimizes inflammation-induced cell damage and DNA mutations, lowering the risk of colorectal cancer precursor lesions. Helminth infection-mediated immunosuppression can hasten colorectal cancer growth and metastasis, which is detrimental to patient outcomes. Some helminth derivatives can activate immune cells to attack cancer cells, making them potentially useful as colorectal cancer vaccines or therapies. This review also covers gene editing approaches. We discovered that using CRISPR/Cas9 to inhibit live helminths modulates miRNA, which limits tumor growth. We propose more multicenter studies into helminth therapy's long-term effects and immune regulation pathways. We hope to treat colorectal cancer patients with helminth therapy and conventional cancer treatments in an integrative setting.

A novel benzofuran derivative of β-elemene (ZT-22) inhibits hepatocellular carcinoma cell growth via directly targeting HSPA6

Hepatocellular carcinoma (HCC) is the fifth most common cancer globally and is associated with a poor prognosis. Current therapies for HCC have limited efficacy and require improvement. In our study, the benzofuran derivative of β-elemene (ZT-22) demonstrated enhanced anti-HCC efficacy compared to β-elemene, both in vitro and in vivo. Using network pharmacology, RNA sequencing, and western blot analysis, the crucial role of the p38 MAPK signaling pathway in the anti-HCC activity of ZT-22 cells was highlighted. Using drug affinity-responsive target stability (DARTS) combined with mass spectrometry (MS), HSPA6 was identified as the target for ZT-22. Techniques such as the cellular thermal shift assay (CETSA), surface plasmon resonance (SPR) analysis, microscale thermophoresis (MST), molecular docking and molecular dynamics (MD) simulations were used for further validation, confirming that ZT-22 directly binds to HSPA6. Knocking down HSPA6 diminished p38 MAPK signaling and reversed the anti-HCC effects of ZT-22. These findings suggest that ZT-22 exerts its anti-HCC activity by targeting HSPA6, which in turn activated the p38-MAPK signaling pathway. Our results support the development of ZT-22 as a potential therapeutic agent for HCC and highlight HSPA6 as a promising therapeutic target for HCC treatment.

Exploring the tumor microenvironment of breast cancer to develop a prognostic model and predict immunotherapy responses

Breast cancer is the most prevalent malignancy in women and exhibits significant heterogeneity. The tumor microenvironment (TME) plays a critical role in tumorigenesis, progression, and response to therapy. However, its impact on the prognosis and immunotherapy responses is incompletely understood. Using public databases, we conducted a comprehensive investigation of transcriptome and single-cell sequencing data. After performing immune infiltration analysis, we conducted consensus clustering, weighted gene co-expression network analysis (WGCNA), Cox regression, and least absolute shrinkage and selection operator (Lasso) regression to identify independent prognostic genes in breast cancer. Subsequently, we developed a prognostic model for patients with breast cancer. Tumor Immune Dysfunction and Exclusion (TIDE) values were used to assess patient's responsiveness to breast cancer. Based on single-cell RNA-sequencing data, we identified various cell types through cluster analysis and investigated the expression of prognostic model genes in each cell type. The drug sensitivity of targeted therapeutic agents for breast cancer treatment was analyzed in different cell types. We identified 12 independent prognostic genes associated with breast cancer and used these genes to construct a prognostic model. The prognostic model accurately discriminated between patients classified as high- and low-risk, providing precise prognostic predictions for individual patients. Additionally, our model exhibited a robust capacity to predict the immunotherapeutic response in breast cancer patients. Our investigation revealed a notable association between the proportion of endothelial cells (ECs) and patient prognosis in breast cancer. A prognostic model for breast cancer was formulated that showed close associations between prognosis and response to immunotherapy. For patients predicted by our model to not respond effectively to immunotherapeutic agents, it may be considered to combine immunotherapeutic agents with targeted therapeutic agents identified through our drug sensitivity analysis, which could potentially enhance treatment efficacy.

A microprotein encoded by LINC00263 promotes breast cancer osteolytic bone metastasis by inducing osteoclastogenesis and inhibiting osteoclast ferroptosis

Currently, there are no effective prevention or therapeutic methods for breast cancer bone metastasis (BC-BM), which leading to severe skeletal complications and increased mortality. Understanding the mechanisms underlying BC-BM could provide potential strategies for its prevention and treatment. In this study, we identified a new microprotein encoded by lncRNA LINC00263, which we named LINC00263-encoded protein (LINC00263-P), was significantly upregulated in bone metastatic breast cancer tissues and correlated with BC-BM. Overexpression of LINC00263 significantly promoted BC-BM, while treatment with the neutralizing anti-LINC00263-P antibody effectively inhibited BC-BM. Mechanically, the LINC00263-P binds to integrin αvβ3 for activating Src/Syk/Vav-3 axis and yes-associated protein 1 (YAP1) pathway, which enhanced osteoclastogenesis and diminishes ferroptosis in osteoclasts, thereby creating an osteolytic bone metastasis niche that fosters BC-BM. Importantly, treatment with angoroside C, an active component from the traditional Chinese medicine Scrophulariae Radix extract, effectively blocked the binding of LINC00263-P to αvβ3, thereby inhibiting abnormal osteoclastogenesis and preventing BC-BM. These findings highlight the crucial role of microprotein LINC00263-P in disrupting bone homeostasis and propose a potential molecular mechanism of BC-BM.

Analysis of hemolysis-associated acute myeloid leukemia genes obtained using weighted gene co-expression network analysis and a Mendelian randomization study

PURPOSE

We used bioinformatics methods and Mendelian randomization (MR) analysis to investigate the hub genes involved in acute myeloid leukemia (AML) and their causal relationship with hemolysis, to explore a new direction for molecular biology research of AML.

METHODS

We first differentially analyzed peripheral blood samples from 62 healthy volunteers and 65 patients with AML from the Gene Expression Omnibus database to obtain differentially expressed genes (DEGs), and intersected them with genes sourced from weighted gene co-expression network analysis (WGCNA) and the GeneCards database to obtain target genes. Target genes were screened using protein-protein interaction (PPI) network analysis and ROC curves to identify genes associated with AML. Finally, we analyzed the correlation between genes and immune cells and the relationship between toll-like receptor 4 (TLR4) and AML using MR.

RESULTS

We compared peripheral blood expression profiles using an array of 62 healthy volunteers (GSE164191) and 65 patients with AML (GSE89565) (M0:25; M1:11; M2:10; M3:1; M4:7; M4 eo t [16;16] ou inv [16]:4; M5:6; M6:1) and obtained 7,339 DEGs (3,733 upregulated and 3,606 downregulated). We intersected these DEGs with 4,724 genes from WGCNA and 1,330 genes related to hemolysis that were identified in the GeneCards database to obtain 190 target genes. After further screening these genes using the PPI network, we identified TLR4, PTPRC, FCGR3B, STAT1, and APOE, which are closely associated with hemolysis in patients with AML. Finally, we found a causal relationship between TLR4 and AML occurrence using MR analysis (p < 0.05).

CONCLUSION

We constructed a WGCNA-based co-expression network and identified hemolysis-associated AML genes.

Aerosol Delivery of Hesperetin-Loaded Nanoparticles and Immunotherapy Increases Survival in a Murine Lung Cancer Model

Flavonoids, like Hesperetin, have been shown to be an ACE2 receptor agonists with antioxidant and pro-apoptotic activity and can induce apoptosis in cancer cells. ACE2 receptors are abundant in lung cancer cells. Here, we explored the application of Hesperetin bound to PegPLGA-coated nanoparticles (Hesperetin nanoparticles, HNPs) and anti-CD40 antibody as an aerosol treatment for lung tumor-bearing mice. The Hesperetin nanoparticles (HNPs) were engineered using a nano-formulation microfluidic technique and polymeric nanoparticles. The in vitro studies were performed in human A549 (ATCC) and murine LL/2-Luc2 (ATCC) lung cancer cell lines. A syngeneic orthotopic murine model of lung cancer was generated in wild (+/+) C57/BL6 background mice with luciferase-positive cell line LL/2-Luc2 cells. Lung tumor-bearing mice were treated via aerosol inhalation with HNP, anti-CD40 antibody, or both. Survival was used to analyze the efficacy of the aerosol treatment. The cohorts were also analyzed for body condition score, weight, and liver and kidney function. Analysis of an orthotopic murine lung cancer model demonstrated a differential uptake of the HNPs and anti-CD40 by the cancer cells. A higher survival rate was observed when the combination of aerosol treatment with HNPs was added with the treatment with anti-CD40 (p < 0.001), as compared to anti-CD40 alone (p < 0.01). Moreover, two tumor-bearing mice survived long-term with the combination treatment, and their tumors were diminished. Subsequently, these two mice were shown to be refractory to the development of subcutaneous tumors, indicating systemic resilience to developing new tumors. Using an inhalation-based administration, we successfully established a treatment model of increased therapeutic efficacy with HNPs and anti-CD40 in an orthotopic murine lung cancer model. Our findings open the possibility of improved lung cancer treatment using nanoparticles like flavonoids and immunoadjuvants.

Daidzein and puerarin synergistically suppress gastric cancer proliferation via STAT3/FAK pathway Inhibition

BACKGROUND

Gastric cancer (GC) is the world's health is seriously threatened by a prevalent form of aggressive tumor with a dismal prognosis. The occurrence of gastric cancer poses a concern for public health since it is a malignant tumor with an enhanced incidence and fatality level.

OBJECTIVE

The purpose of this study was to determine if the natural drug Daidzein (DZN) and Puerarin (PRN) together effectively suppress the proliferation of GC cells by blocking the STAT3/FAK intervention signalling pathways in BGC-823 cells.

MATERIALS AND METHODS

Following a 24-hour treatment with the combination of DZN and PRN, the cells were examined for a number of assays. The MTT test was used to investigate the cytotoxicity of the DZN + PNR combination. Acridine orange/ethidium bromide (AO/EtBr) dual staining experiments were utilized to investigate apoptotic alterations, and Western blotting and flow cytometry were used to assess the protein expressions of the cell survival, cell cycle, proliferation, and apoptosis proteins.

RESULTS

Our findings showed that, DZN and PRN possessed anticancer properties by blocking the STAT3/FAK signaling cascade. Moreover, we discovered that the DZN and PRN combo reduced the protein levels of STAT3-FAK-dependent targeted genes, such as cyclin-D1, Bcl-2, Bax, MMP-2, prevented the phosphorylation and activation of STAT3, FAK.

CONCLUSION

The current study's findings suggest that the simultaneous administration of DZN and PNR can stop gastric cancer cells from proliferating, trigger apoptosis, and disrupt their cell cycle.

Construction and validation of a nomogram for identifying the patients at risk for rapid progression of advanced hormone-sensitive prostate cancer

BACKGROUND

This study aimed to evaluate the prognostic significance of lactate dehydrogenase (LDH) and fasting triglyceride-glucose (TyG) index in advanced hormone-sensitive prostate cancer (HSPC) patients, with the ultimate goal of developing and validating a nomogram for predicting castration-resistant prostate cancer (CRPC) free survival.

MATERIALS AND METHODS

The follow-up data of 207 CRPC patients who had androgen deprivation therapy as their initial and only treatment before progression were retrospectively reviewed. To assess prognostic variables, univariate and multivariate Cox regression analyses were performed. The concordance index (C-index), calibration curves, receiver operating characteristic (ROC) curves, and decision curve analyses (DCA) were utilized to construct and test a novel nomogram model.

RESULTS

TyG index, LDH, M stage and Gleason sum were determined to be independent prognostic markers and were combined to create a nomogram. This nomogram worked well in the tailored prediction of CRPC development at the sixth, twelve, eighteen, and twenty-fourth months. The C-indexes for the training and validation sets were 0.798 and 0.790, respectively. The ROC curves, calibration plots, and DCA all indicated good discrimination and prediction performance. Furthermore, the nomogram had a higher prognostic ability than the M stage and the Gleason sum. The nomogram-related risk score classified the patient population into two groups with significant progression differences.

CONCLUSIONS

The created nomogram could help identify patients at high risk for rapid progression of advanced HSPC, allowing for the formulation of tailored therapy regimens and follow-up methods in a timely manner.

Prostate Cancer Mortality in Iranian Men During 1990-2021: An Age-Period-Cohort and Joinpoint Regression Analysis

Background: Prostate cancer (PC) ranks as the third cause of cancer-related deaths among Iranian men. The age-period-cohort (APC) model helps identify critical ages, periods, and high-risk birth cohorts to prevent and control PC. Thus, this research aimed to evaluate the effect of APC on PC mortality in Iran from 1990 to 2021. Method: Our data include the number of PC deaths and population, collected by the Global Burden of Disease (GBD) and categorized by 5-year age groups. We computed average annual percentage changes (AAPCs) and relative risks by using joinpoint regression analysis and APC models, respectively. Results: Crude and age-standardized mortality rates for PC were increasing, with AAPC of 2.254% (95% CI: 2.099% and 2.410%; p < 0.001) and 0.257% (95% CI: 0.088% and 0.428%; p < 0.001), respectively. Furthermore, an increase occurred in both age effect from ages 20-24 years (RR = 0.033; 95% CI: 0.023 and 0.046) to over 95 years (RR = 16.183; 95% CI: 14.702 and 17.814) and the period from 1992 (RR = 0.542; 95% CI: 0.516 and 0.570) to 2021 (RR = 1.892; 95% CI: 1.809 and 1.979). While, the cohort effect demonstrated a lower mortality rate in later born than earlier born (Coef = 2.302 for the < 1901 cohort compared to Coef = -2.249 for the 2002-2006 cohort). Conclusion: Our study indicated that the trend of PC deaths in Iran increased during 1990-2021, and the period effect confirms this. Considering fewer deaths in high-income countries due to the widespread implementation of PSA testing, the occurrence of the aging phenomenon in our country, and the upward trend in deaths related to the age effect, sensitizing people and policymakers to conduct PSA screening seems necessary.