Qingcong Kong, Yongxin Chen, Yi Sui, Siyi Chen, Xinghan Lv, Wenjie Tang, Zhidan Zhong, Xiaomeng Yu, Kuiming Jiang, Lei Zhang, Jianning Chen, Jie Qin, Yuan Guo
{"title":"The Role of Multiparametric MRI Radiomics for Preoperative Prediction of Axillary Lymph Node Metastasis in Patients With Invasive Breast Cancer: A Comparative Study","authors":"Qingcong Kong, Yongxin Chen, Yi Sui, Siyi Chen, Xinghan Lv, Wenjie Tang, Zhidan Zhong, Xiaomeng Yu, Kuiming Jiang, Lei Zhang, Jianning Chen, Jie Qin, Yuan Guo","doi":"10.1002/cai2.70022","DOIUrl":"https://doi.org/10.1002/cai2.70022","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The predictive value of different MRI sequences for axillary lymph node metastasis (ALNM) in patients with invasive breast cancer remains unclear. This study compared the performance of radiomics models based on individual and combined MRI sequences for the preoperative prediction of ALNM and evaluated the clinical application value of the optimal model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This retrospective study included 454 patients (mean ± SD age 50.9 ± 10.7 years) diagnosed with invasive breast cancer from two centers, with 382 patients from Center 1 (training cohort) and 72 patients from Center 2 (external test cohort). Tumor segmentation and radiomics feature extraction were performed on T2-weighted imaging (T2WI), diffusion-weighted imaging (DWI), and dynamic contrast-enhanced (DCE) images. The least absolute shrinkage and selection operator with 10-fold cross-validation was used for feature selection and radiomics score construction. Three single-sequence models and one multi-sequence radiomics model were developed, and the optimal model was combined with conventional MRI features to create a combined MRI model. The combined model's performance was compared to radiologists' diagnoses. A nomogram was developed based on the optimal model and correlated with prognosis using the Kaplan–Meier curve and Cox proportional hazard regression. Model performance was evaluated using area under the curve (AUC); DeLong's test was used for comparison.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In the external test cohort, the DCE model showed the highest performance (AUC = 0.76) but was not significantly different from T2WI (AUC = 0.72) and DWI (AUC = 0.70) (all <i>p</i> > 0.05). The combined radiomics model achieved an AUC of 0.82, outperforming DWI and T2WI (<i>p</i> < 0.05), but was not significantly different from the DCE model (<i>p</i> > 0.05). The combined MRI model demonstrated the highest AUC of 0.84 and notably improved radiologist diagnostic accuracy. A nomogram based on the combined MRI model was developed to assist clinical decision-making by providing individualized risk predictions. The higher-risk group based on the model's predictive probability showed a significantly worse prognosis (<i>p</i> < 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The combined radiomics model outperformed single-sequence models in predicting ALNM. The combined MRI model demonstrated the highest performance, improving diagnostic accuracy and showing potential for prognostic prediction.</p","PeriodicalId":100212,"journal":{"name":"Cancer Innovation","volume":"4 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cai2.70022","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144615273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Xiangyi Kong, Qiang Liu, Zheng Qu, Xiangyu Wang, Wenxiang Zhang, Yulu Liu, Robert Coleman, Chunqing Lin, Jing Wang
{"title":"Mapping the Metastatic Landscape: A Population-Based Cohort Study for Prognostic Insights Into Newly Diagnosed Stage IV Breast Cancer Cases","authors":"Xiangyi Kong, Qiang Liu, Zheng Qu, Xiangyu Wang, Wenxiang Zhang, Yulu Liu, Robert Coleman, Chunqing Lin, Jing Wang","doi":"10.1002/cai2.70017","DOIUrl":"https://doi.org/10.1002/cai2.70017","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Breast cancer is the most common malignancy and a leading cause of cancer-related deaths among women worldwide. Although treatment advances have improved outcomes, the 5-year survival rate for metastatic breast cancer remains low. Understanding the anatomical distribution, associated risks, and prognostic features of metastases in patients with newly diagnosed stage IV breast cancer is essential for improving clinical management. This study aims to comprehensively investigate these aspects using data from the SEER database.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study utilized a retrospective cohort design, examining data from the Surveillance, Epidemiology, and End Results (SEER) database. The investigation considered patients diagnosed with stage IV breast cancer from SEER database. Using logistic regression, odds ratios (ORs) were calculated to determine the risk of various metastases, stratified based on sociodemographic and clinicopathological variables. Survival analyses were executed with Kaplan–Meier methodology in tandem with Cox regression analyses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Out of 356,789 breast cancer patients considered, 18,036 (5.06%) were diagnosed with de novo stage IV disease. Bone metastasis predominated with a composition ratio of 42.6%. Patients with the HR−/HER2+ subtype exhibited the highest metastasis incidence at the time of diagnosis, constituting 8.7% of the entire cohort. Male patients displayed heightened susceptibility to bone, lung, and brain metastases compared to female counterparts. Hispanic individuals exhibited the highest propensity for brain metastases. Relative to other subtypes, the HR−/HER2− patients were more inclined toward lung metastases. Those with bone metastasis had a median survival period of 27 months. Grade III patients with brain or liver metastases faced the most adverse prognoses. A comprehensive profile detailing metastasis patterns by demographics, tumor site and stage, biology, and treatment was presented.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study represents the most comprehensive analysis of metastasis' anatomical distribution and prognosis in breast cancer, offering invaluable insights into metastatic tendencies and characteristics.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100212,"journal":{"name":"Cancer Innovation","volume":"4 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cai2.70017","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144598566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Global Trajectories of Colorectal Cancer Burden From 1990 to 2021 and Projection to 2040","authors":"Xiaolu Chen, Xuesi Dong, Yadi Zheng, Chenran Wang, Zilin Luo, Jiaxin Xie, Zeming Guo, Xiaoyue Shi, Xinyue Zhu, Yongjie Xu, Wei Cao, Fei Wang, Ni Li","doi":"10.1002/cai2.70020","DOIUrl":"https://doi.org/10.1002/cai2.70020","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>There is significant heterogeneity in patterns of colorectal cancer burden, which is still not well understood. This study examines global trajectories in the colorectal cancer burden, explores associated factors, and predicts future trends.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data on the colorectal cancer burden for 204 countries and territories from 1990 to 2021 were sourced from the Global Burden of Disease Study. Growth mixture models identified subgroups of age-standardized incidence and mortality rates. Eleven modifiable risk factors and four socioeconomic determinants were analyzed across the subgroups. Trends to 2040 were predicted using a Bayesian age-period-cohort model.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Three trajectories of colorectal cancer burden were observed: slowly increasing, rapidly increasing, and slowly decreasing age-standardized incidence rate, corresponding to stable, increasing, and decreasing mortality rate. Most countries showed slowly increasing incidence rates (49.0%, <i>n</i> = 100) and stable age-standardized mortality rates (51.0%, <i>n</i> = 104). Latin America and the Caribbean predominantly have a rapidly increasing trend (age-standardized incidence: 69.7%; mortality rates: 63.6%), while high-income countries largely followed decreasing trajectories (incidence: 58.3%; mortality: 75.0%). Higher sociodemographic index, universal health coverage, health expenditure, and gross domestic product per capita were linked to decreasing trends (all <i>p</i> < 0.05). Low consumption of whole grains and milk, and excessive red meat consumption, contributed significantly to colorectal cancer mortality. However, the impact of behavioral factors such as physical inactivity, smoking, and alcohol consumption was relatively small. Mortality attributable to high fasting blood sugar and body mass index is rising. Despite a slight global decline in mortality, disparities are projected to persist through 2040.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Global disparities in colorectal cancer burden highlight the need for targeted interventions, particularly focusing on dietary factors and health inequities.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100212,"journal":{"name":"Cancer Innovation","volume":"4 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cai2.70020","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144582231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Advances in Cellular Immune Theranostic Approaches for Glioblastoma: Current Trends and Future Directions","authors":"Ying Gong, Wanying Lin, Xuechun Fang, Ruyi Zhang, Min Luo, Haoran Wu, Shuai Chu, Chuangkun Li, Yiming Peng, Zhiyan Piao, Siping Wu, Junhao Li, ZongZhong He, Haixia Li, Hongxia Wang","doi":"10.1002/cai2.70018","DOIUrl":"https://doi.org/10.1002/cai2.70018","url":null,"abstract":"<p>Glioblastoma is a highly malignant type of brain tumor that remains one of the most challenging cancers to treat because of its aggressive nature, genetic heterogeneity, and immunosuppressive tumor microenvironment. Despite advances in standard treatments, such as surgery, radiation, and chemotherapy, patient outcomes remain poor, driving the need for innovative therapeutic approaches. Cellular immune theranostics, which combines therapeutic and diagnostic capabilities, has emerged as a promising strategy to combat glioblastoma. The present review discusses recent advances in cellular immunotherapy, including the development and application of chimeric antigen receptor T cells, chimeric antigen receptor natural killer cells, and macrophage-based therapies. In addition, this review highlights the potential of oncolytic viruses and personalized tumor vaccines for improving immunotherapy outcomes. The integration of advanced diagnostic tools, such as the real-time monitoring of therapeutic responses through immunobiomarkers and imaging techniques, is emphasized as crucial for optimizing treatment strategies. However, important challenges remain, including the complexity of immune cell engineering, the difficulties of therapeutic delivery across the blood–brain barrier, and the immunosuppressive properties of the tumor microenvironment. Overcoming these challenges through innovative methodologies will be vital for improving the efficacy of cellular immune theranostics in the treatment of glioblastoma, with the ultimate goal of improving patient survival and quality of life.</p>","PeriodicalId":100212,"journal":{"name":"Cancer Innovation","volume":"4 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cai2.70018","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144551111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Xiaomei Yao, Ashirbani Saha, Sharan Saravanan, Ashley Low, Jonathan Sussman
{"title":"A Study Protocol for a Comprehensive Evaluation of Two Artificial Intelligence-Based Tools in Title and Abstract Screening for the Development of Evidence-Based Cancer Guidelines","authors":"Xiaomei Yao, Ashirbani Saha, Sharan Saravanan, Ashley Low, Jonathan Sussman","doi":"10.1002/cai2.70021","DOIUrl":"https://doi.org/10.1002/cai2.70021","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Conducting a systematic review (SR) is a time-intensive process and represents the first phase in developing a clinical practice guideline (CPG). Completing a CPG through the Program in Evidence-Based Care (PEBC), a globally acknowledged guideline program supported by Ontario Health (Cancer Care Ontario), typically takes about 2 years. Thus, expediting an SR can significantly reduce the overall time required to complete a CPG. Our recently published review identified two artificial intelligence (AI) tools, DistillerSR and EPPI-Reviewer that reduced time in the title and abstract screening in an SR process when developing a CPG. However, the consistency and generalizability of these tools remain unclear within or across different SRs related to cancer. This study protocol aims to evaluate and compare the performance of DistillerSR and EPPI-Reviewer against human reviewers for title and abstract screening (Stage I screening) in cancer CPG development.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We will conduct a retrospective simulation study to evaluate and compare the performance of DistillerSR and EPPI-Reviewer across 10 previously published CPGs by PEBC. These CPGs include the five cancer types with the highest incidence (lung, breast, prostate, colorectal, and bladder). We will run 30 simulation trials for one CPG per AI tool. Primary outcomes are workload savings and time savings in Stage I screening. The secondary outcome is the percentage of missing articles among the final included articles. This informs the accuracy and comprehensiveness of the AI tools. Descriptive and inferential statistical analysis will be conducted to evaluate the outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>This is a study protocol. The data presented in the tables are illustrative examples rather than actual study results, in accordance with the journal s standard structure. All data included in the final study will be thoroughly validated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>This will be the first study to investigate and compare the performance of DistillerSR and EPPI-Reviewer in Stage I screening of SRs in CPGs across different cancer types. These findings will inform the reliable use of AI tools in future cancer-related CPGs. The results from this retrospective study will need to be confirmed by prospective studies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100212,"journal":{"name":"Cancer Innovation","volume":"4 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cai2.70021","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144514973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Artificial Intelligence-Based Methods: The Path Forward in Achieving Equity in Lung Cancer Screening and Evaluation","authors":"Stephen J. Kuperberg, David C. Christiani","doi":"10.1002/cai2.70019","DOIUrl":"https://doi.org/10.1002/cai2.70019","url":null,"abstract":"<p>Although lung cancer remains a global threat to public health, evidenced based advances in screening and prevention hold promise for reducing its impact on mortality. An ongoing challenge facing the clinical and research community are the glaring disparities in access to preventive services faced by ethnically and socioeconomically marginalized groups. In this context, novel approaches are needed to improve research methods and thus bolster our ability to improve outcomes. Artificial intelligence (AI) applications such as machine learning and natural language processing hold promise as catalysts in this process, enhancing speed, accuracy and capability. This perspective will highlight the potential of AI methods as essential tool for growth across the lung cancer diagnostic continuum from screening to diagnosis.\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":100212,"journal":{"name":"Cancer Innovation","volume":"4 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cai2.70019","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144323529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Zheng Qu, Zheng Li, Shengbin Pei, Ye Lu, Qiang Liu, Peikai Ding, Yazhe Yang, Luxiao Zhang, Jing Wang, Yi Fang
{"title":"Global, Regional, and National Burden of Breast Cancer in Adolescents and Young Adults Aged 15–39 Years From 1990 to 2021 Based on the Global Burden of Disease Study 2021","authors":"Zheng Qu, Zheng Li, Shengbin Pei, Ye Lu, Qiang Liu, Peikai Ding, Yazhe Yang, Luxiao Zhang, Jing Wang, Yi Fang","doi":"10.1002/cai2.70016","DOIUrl":"https://doi.org/10.1002/cai2.70016","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Breast cancer (BC) remains a significant global public health challenge, and its incidence and mortality rates among adolescents and young adults (AYAs) aged 15–39 years are increasing. Compared with older adults, AYAs often face poorer prognoses and a higher disease burden. Understanding the trends and determinants of BC burden in AYAs is crucial for guiding preventive measures, early detection programs, and treatment strategies. The aim of this study is to systematically investigate the trends and distribution of the BC burden among AYAs aged 15–39 years across regions and countries and identify the contributing risk factors and disparities in incidence, mortality, and disability-adjusted life years (DALYs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Data on BC were collected from the Global Burden of Disease (GBD) 2021 database. The number of cases, age-standardized rates, mortality, and DALYs for BC were assessed for 204 countries and territories from 1990 to 2021. Joinpoint regression analysis was used to calculate the average annual percentage changes (AAPCs) in incidence, mortality, and DALYs. Risk factors that contribute to the BC burden were also evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>According to GBD 2021 estimates, 180,791 new BC cases and 42,055 related deaths were observed among AYAs globally. Between 1990 and 2021, the global incidence rate increased by 33.4%, with the highest incidence observed in regions with a high sociodemographic index (SDI) and the highest mortality rates in low-SDI regions. Incidence rates in women showed a significant upward trend (AAPC, 3.03) and peaked in North Africa and the Middle East, whereas the most rapid increase in incidence in men was noted in East Asia (AAPC, 4.87). Projections indicated a decline in age-standardized incidence rates across most European countries by 2050, in contrast to rising trends in Asia and Africa. Risk factor analysis identified dietary risks (10.5%), tobacco smoking (2%), and high fasting plasma glucose (1.6%) as major contributors to DALYs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The global burden of AYA BC has increased significantly, particularly in regions with a middle and low SDI. The findings highlight the need for targeted preventive interventions for high-risk populations and provide critical insights for developing regional control strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100212,"journal":{"name":"Cancer Innovation","volume":"4 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cai2.70016","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144220055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Prediction of Therapeutic Response and Prognosis in Ovarian Cancer Patients With Plasma Circulating Biomarkers","authors":"Haixia Cheng, Guangwen Yuan, Leilei Liang, Tiantian Wang, Jiarun Zhu, Hongying Yang, Zhendiao Zhou, Pei Wang, Qianqian Song, Yuchen Jiao, Mei Liu, Lingying Wu","doi":"10.1002/cai2.70014","DOIUrl":"https://doi.org/10.1002/cai2.70014","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>To assess whether changes in TP53 mutations and copy number alterations (CNA) in plasma circulating tumor DNA (ctDNA) can predict treatment response and prognosis in platinum-resistant recurrent ovarian cancer (PROC) patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Fifty-seven PROC patients were recruited. Forty-three patients with matched tumor and plasma samples were analyzed via both a tumor-informed ctDNA assay (TICA) and a tumor-uninformed ctDNA assay (TUCA) profiling TP53 mutations and CNA. The TUCA algorithm was optimized based on TICA results. Fourteen patients without matched tumor tissues were used just for TUCA analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A ctDNA decrease of ≥ 80% from baseline or ctDNA negativity during treatment detected by the TICA (defined as favorable TICA changes) strategy before the third cycle predicted the best overall response, with 81.8% sensitivity and 84.6% specificity. The TUCA strategy was defined as a combination of TP53 mutations and CNA changes. A favorable TUCA change before the third cycle predicted the best overall response, with 90.0% sensitivity and 63.2% specificity. In 12 patients without clinical benefit, the median lead time to detect drug resistance from TUCA to the Response Evaluation Criteria in Solid Tumors was 86.0 days. Patients with favorable ctDNA changes (<i>n</i> = 15) detected by TUCA before the third cycle had a median progression-free survival of 9.2 months, versus 3.6 months in those without (<i>n</i> = 34) (HR: 2.88; 95% CI 1.56–5.30; log-rank <i>p</i> = 0.0008).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Similar to TICA, ctDNA changes detected by TUCA combined with TP53 mutations and CNA could predict treatment response and prognosis in PROC patients without requiring tumor tissues.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100212,"journal":{"name":"Cancer Innovation","volume":"4 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cai2.70014","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144214128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Diagnostic Value of PET/CT for Ovarian Cancer Recurrence or Metastasis in Postoperative Patients With Elevated Serum CA125 Levels: A Systematic Review and Meta-Analysis","authors":"Zuowei Zou, Luhua Xia, Saikang Tang, Lin Lin, Quanyang Wu, Donghui Hou, Shijun Zhao","doi":"10.1002/cai2.70015","DOIUrl":"https://doi.org/10.1002/cai2.70015","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Ovarian cancer patients with elevated serum CA125 levels after operation have a high incidence of relapse or metastasis. <sup>18</sup>F-FDG PET/CT is an effective imaging method for identifying recurrent or metastatic lesions. This study systematically investigated the diagnostic value of <sup>18</sup>F-FDG PET/CT in this patient population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A systematic search of PubMed, Embase, Cochrane Library (Central), Web of Science (SCI-Expanded), and Chinese databases (CNKI, VIP database, Wan Fang Data, CBM) was performed. Studies that evaluated the diagnostic value of <sup>18</sup>F-FDG PET/CT for relapse or dissemination in postoperative ovarian cancer patients with elevated serum CA125 levels were included. The methodological quality of the studies was evaluated using the Quality Assessment of Diagnostic Accuracy Studies 2 tool. Data were analyzed for heterogeneity using Meta-Disc 1.4 software. Sensitivity analysis and release bias evaluation were conducted using STATA 14.0 software.</p>\u0000 \u0000 <p>Thirteen studies (including 421 female patients) qualified for the meta-analysis. The pooled sensitivity and specificity of <sup>18</sup>F-FDG PET/CT were 0.94 (95% CI: 0.91–0.97) and 0.83 (95% CI: 0.71–0.91), respectively. The pooled positive likelihood proportion was 4.59 (95% CI: 2.81–7.51), the pooled negative likelihood proportion was 0.09 (95% CI: 0.05–0.15), and the pooled diagnostic odds ratio was 64.22 (95% CI: 27.21–151.57). The area under the curve was 0.9379. A sensitivity analysis and publication bias test indicated that the outcomes were steady, and there was no reporting bias.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p><sup>18</sup>F-FDG PET/CT has high diagnostic veracity for identifying recurrence or metastasis in ovarian cancer cases with increased serum CA125 levels after surgery. It can accurately detect recurrent or metastatic lesions, providing valuable information for clinical decision-making.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100212,"journal":{"name":"Cancer Innovation","volume":"4 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cai2.70015","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144197298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Feng Du, Jie Ju, Fangchao Zheng, Songlin Gao, Peng Yuan
{"title":"The Identification of Novel Prognostic and Predictive Biomarkers in Breast Cancer via the Elucidation of Tumor Ecotypes Using Ecotyper","authors":"Feng Du, Jie Ju, Fangchao Zheng, Songlin Gao, Peng Yuan","doi":"10.1002/cai2.70013","DOIUrl":"https://doi.org/10.1002/cai2.70013","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Breast cancer is a highly heterogeneous disease, characterized by tumor and nontumor cells at various cell states. Ecotyper is an innovative machine learning framework that quantifies the tumor microenvironment and delineates the tumor ecosystem, demonstrating clinical significance. However, further validation is needed in breast cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Ecotyper was applied to identify multiple cellular states and tumor ecotypes using large-scale breast cancer bulk sequencing data, followed by a detailed analysis of their associations with clinical classification, molecular subtypes, survival prognosis, and immunotherapy response. Identified subtypes were further characterized using single-cell and spatial data sets to reveal molecular profiles.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>In a comprehensive analysis of 6578 breast cancer samples from four data sets, Ecotyper identified 69 cellular states and 10 tumor ecotypes. Of these, 37 cellular states significantly correlated with overall survival. Notably, specific states within epithelial cells, macrophages/monocytes, and fibroblasts were linked to a worse prognosis. CE2 abundance was identified as the most significant marker indicating unfavorable prognosis and was further validated in an additional data set of 116 HER2-negative patients. These biomarkers also indicated the efficacy of neoadjuvant immunotherapy in breast cancer. CE2-high cancers were characterized by an abundance of basal-like epithelial cells, scant lymphocytic infiltration, and activation of hypoxia signaling. Single-cell analysis showed that CE2-high areas were rich in SPP1-positive tumor-associated macrophages(TAM), basal-like epithelial cells, and hypoxic cancer-associated fibroblasts(CAF). Spatially, these regions were often peripheral in triple-negative breast cancer, adjacent to fibrotic/necrotic zones. Multiplex immunofluorescence confirmed the enrichment of SPP1+CD68+TAM and HIF1A+SMA+CAF in hypoxic triple-negative breast cancer (TNBC) regions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Ecotyper identified novel biomarkers for breast cancer prognosis and treatment prediction. The CE2-high region may represent a hypoxic immune-suppressive niche.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100212,"journal":{"name":"Cancer Innovation","volume":"4 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cai2.70013","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144140424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}