Frontiers in Oncology最新文献

{"title":"Correction: MiR-29b-3p inhibits migration and invasion of papillary thyroid carcinoma by down-regulating COL1A1 and COL5A1.","authors":"Congjun Wang, Ye Wang, Zhao Fu, Weijia Huang, Zhu Yu, Jiancheng Wang, Kaitian Zheng, Siwen Zhang, Shen Li, Junqiang Chen","doi":"10.3389/fonc.2025.1657780","DOIUrl":"https://doi.org/10.3389/fonc.2025.1657780","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.3389/fonc.2022.837581.].</p>","PeriodicalId":12482,"journal":{"name":"Frontiers in Oncology","volume":"15 ","pages":"1657780"},"PeriodicalIF":3.5,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12532127/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145328655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient-derived organoid facilitating personalized medicine in non-small cell lung cancer: two case reports.","authors":"Lili Qin, Shasha Wang, Liping Li, Haifeng Qin","doi":"10.3389/fonc.2025.1674897","DOIUrl":"10.3389/fonc.2025.1674897","url":null,"abstract":"<p><p>Patients with brain metastases from lung cancer exhibit rapid disease progression and a poor prognosis, underscoring an urgent need for effective therapeutic strategies. Drug sensitivity testing using patient-derived organoids (PDOs) has emerged as a promising tool for guiding clinical treatment decisions. Here, we report two cases of non-small cell lung cancer (NSCLC) with brain metastases where treatment guided by PDO-based drug sensitivity screening aided in disease control. Case 1 involved a patient with an EGFR exon 19 deletion. The corresponding PDO model demonstrated sensitivity to a combination of pemetrexed, carboplatin, and osimertinib, but insensitivity to osimertinib monotherapy. Following this guidance, the patient achieved a partial response (PR) to the triplet regimen and was subsequently de-escalated to maintenance therapy. The patient's disease remained stable at the time of this report. Case 2 involved a patient with a complex EML4-ALK fusion variant 3 (E6:A20) and a novel NRXN1-ALK fusion (N19:A20). The patient had progressed on multiple lines of therapy, including alectinib and lorlatinib. The PDO model showed sensitivity to brigatinib but insensitivity to ensartinib. Subsequent treatment with brigatinib induced a PR that was sustained for 5.8 months; the patient survived for a total of 9 months following the initiation of this PDO-guided therapy. These two cases suggests that PDOs derived from primary and metastatic lesions may help optimize treatment regimens for patients with lung cancer brain metastases, thereby enabling personalized therapy and potentially improving survival outcomes.</p>","PeriodicalId":12482,"journal":{"name":"Frontiers in Oncology","volume":"15 ","pages":"1674897"},"PeriodicalIF":3.5,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12531068/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145328537","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Next-generation sequencing-based genomic profiling of advanced soft tissue and bone sarcomas.","authors":"Yasemin Gündoğdu, Elif Şenocak Taşçı, Leyla Özer, Can Boynukara, Recep Çeçen, Arda Ulaş Mutlu, İbrahim Yıldız","doi":"10.3389/fonc.2025.1627452","DOIUrl":"10.3389/fonc.2025.1627452","url":null,"abstract":"<p><strong>Background: </strong>Sarcomas are rare mesenchymal tumors classified into soft tissue (STS) and bone sarcomas. Despite advances in treatment, the 5-year survival rate for metastatic disease remains low. There is still limited evidence regarding the use of next-generation sequencing (NGS).</p><p><strong>Aim: </strong>To identify targetable genomic alterations that may play a crucial role in sarcoma treatment where therapeutic options are limited.</p><p><strong>Study design: </strong><b>Methods:</b> We conducted a retrospective; multicenter analysis of 81 patients diagnosed with STS and bone sarcomas who underwent NGS at Acıbadem Health Group Hospitals to investigate their mutation profiles and explore potential targeted therapies.</p><p><strong>Results: </strong>Genomic profiling using four different NGS kits identified a total of 223 genomic alterations across the cohort. Genomic alterations were detectable in 90.1% of patients, with the most common types being copy number amplifications (26.9%) and deletions (24.7%). In addition, actionable mutations were identified in 22.2% of patients, rendering them eligible for FDA-approved targeted therapies. The most common alterations were found in <i>TP53</i> (38%), <i>RB1</i> (22%), and <i>CDKN2A</i> (14%) genes. Among the 79 patients with available microsatellite status data, all were microsatellite stable.</p><p><strong>Conclusion: </strong>The high proportion of patients eligible for targeted therapies identified underscores the critical need to integrate NGS-derived genetic insights into clinical practice to improve survival rates and treatment outcomes through more tailored therapeutic approaches for each individual. NGS also led to a reclassification of diagnosis in four patients, demonstrating its utility not only in therapeutic decision-making but also as a powerful diagnostic tool.</p>","PeriodicalId":12482,"journal":{"name":"Frontiers in Oncology","volume":"15 ","pages":"1627452"},"PeriodicalIF":3.5,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12531057/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145328544","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic value of lymphocyte to monocyte ratio for the patients with bladder cancer: a systematic review and meta-analysis.","authors":"Qiang Ren, Yumin Li, Hankai Chen, Yirun Chen","doi":"10.3389/fonc.2025.1601040","DOIUrl":"10.3389/fonc.2025.1601040","url":null,"abstract":"<p><strong>Objectives: </strong>To provide a meta-analysis evaluating the predictive value of lymphocyte to monocyte ratio (LMR) in the efficacy and prognosis of bladder cancer patients.</p><p><strong>Methods: </strong>Web of Science, Embase, Cochrane, and PubMed for literature searching up to November 2024 to identify research assessing the prognostic significance of LMR in bladder cancer patients. Outcomes included overall survival (OS), relapse-free survival (RFS), progression-free survival (PFS), and cancer-specific survival (CSS). Hazard ratios (HR) and 95% confidence intervals (CI) were used for data pooling of survival variables. In addition, for investigating potential heterogeneity sources and assessing the stability of the findings, sensitivity and subgroup analysis were performed. Review Manger 5.4 and STATA 15.1 were used to analyze.</p><p><strong>Results: </strong>Seventeen studies with 7,968 patients with bladder cancer included. The results indicated a notably shorter OS (HR: 1.56; 95% CI: 1.29, 1.89; <i>P</i> <0.00001), RFS (HR: 1.74; 95% CI: 1.27, 2.36; <i>P</i> = 0.0005), PFS (HR: 2.04; 95% CI: 1.58, 2.64; <i>P</i><0.00001) and CSS (HR: 1.24; 95% CI: 1.01, 1.52; <i>P</i> = 0.04) in patients with low LMR compared to those with high LMR. Furthermore, subgroup analysis of OS found that study design, region, and age were the main factors affecting the correlation between LMR and OS.</p><p><strong>Conclusions: </strong>LMR can effectively predict the survival and recurrence risk of bladder cancer patients, helpingin the improvement of their prognosis. Future research should focus on large-scale, multicenter prospective cohort studies are still required in the future to evaluate the predictive value of LMR bladder cancer patients.</p><p><strong>Systematic review registration: </strong>https://www.crd.york.ac.uk/PROSPERO/view/CRD42024618066 PROSPERO (CRD42024618066).</p>","PeriodicalId":12482,"journal":{"name":"Frontiers in Oncology","volume":"15 ","pages":"1601040"},"PeriodicalIF":3.5,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12532007/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145328594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improvement of revised international staging system risk stratification in patients with newly diagnosed multiple myeloma using a high bone marrow plasma cell percentage: a real-world study in China.","authors":"Xiaoman Sun, Min Song, Pengyu Wang, Zhongmei Zhang, Rongqin Dai, Jie Shi","doi":"10.3389/fonc.2025.1627653","DOIUrl":"10.3389/fonc.2025.1627653","url":null,"abstract":"<p><p>Multiple myeloma (MM) is a heterogeneous malignant plasma cell neoplasm. A significant increase in the bone marrow plasma cell percentage (BMPC%) may adversely affect prognosis. However, a high BMPC% has not been clearly defined. The Revised International Staging System (R-ISS) is considered the standard risk stratification model for newly diagnosed MM (NDMM) and is widely used to assess prognosis. However, a significant proportion of patients were categorized as R-ISS stage II due to high heterogeneity within the population, complicating the accurate prediction of prognosis. This study included 208 patients who were diagnosed with NDMM and received standardized treatment between January 2018 and May 2023, and were categorized into low, medium, and high BMPC% groups. The Kaplan-Meier method was utilized to estimate the progression-free survival (PFS) and overall survival (OS). The Cox proportional hazards model was used to estimate the relationship between BMPC% and survival in patients with R-ISS stage II. The results indicated that a high BMPC% significantly negatively affected OS (hazard ratio [HR] = 4.13, <i>p</i> = 0.002), indicating an adverse prognostic factor. Compared with the low and intermediate BMPC% groups, the high BMPC% group exhibited the shortest median survival time (<i>p</i> < 0.001). Additionally, we analyzed the effect of BMPC% on survival rates stratified by R-ISS stage. Within the stage II subgroup, the OS for the BMPC% stratified groups were NA, 50.1 months, and 29.6 months (<i>p</i> = 0.01). We used external validation to confirm the reliability of the results. The results also indicated that a high BMPC% significantly negatively affected OS (<i>p</i> < 0.001). This study demonstrated that including a BMPC% ≥ 50% can enhance the predictive value of the R-ISS for NDMM, particularly in patients with R-ISS stage II.</p>","PeriodicalId":12482,"journal":{"name":"Frontiers in Oncology","volume":"15 ","pages":"1627653"},"PeriodicalIF":3.5,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12531031/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145328740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ibrutinib combined with rituximab and high-dose methotrexate in newly diagnosed primary CNS diffuse large B-cell lymphoma: a pilot study with long-term follow-up.","authors":"Yixian Guo, Yongzhi Shan, Yueshan Piao, Xiaoli Chang, Dongmei Zou, Qiang Ma, Yukui Wei, Geng Xu, Yaming Wang, Dandan Wang, Lianghong Teng, Chunxue Wu, Zhilian Zhao, Tianbin Song, Hong Zhao, Wuhan Hui, Li Su, Wanling Sun","doi":"10.3389/fonc.2025.1669385","DOIUrl":"10.3389/fonc.2025.1669385","url":null,"abstract":"<p><strong>Key point: </strong>IRM appears promising and well tolerated as first-line therapy for newly diagnosed PCNS DLBCL in a small pilot cohort; these hypothesis-generating results require confirmation in larger prospective studies.</p><p><strong>Background: </strong>Primary diffuse large B-cell lymphoma of the central nervous system (PCNS DLBCL) is a rare, aggressive lymphoma with rising incidence in elderly patients. Bruton tyrosine kinase (BTK) inhibitors show promise in recurrent/refractory cases, warranting exploration in newly diagnosed disease.</p><p><strong>Methods: </strong>This single-center pilot study evaluated the safety/efficacy of ibrutinib, rituximab, and high-dose methotrexate (IRM) in nine newly diagnosed PCNS DLBCL patients (2018-2019). Treatment included 4 cycles of IRM induction, consolidation (HSCT or 2 additional IRM cycles), and maintenance therapy (ibrutinib/lenalidomide).</p><p><strong>Results: </strong>After induction, overall response rate (ORR) was 100% (complete response [CR]: 77.8%, partial response [PR]: 22.2%). Post-consolidation, CR increased to 88.9%. At a median follow-up of 77.6 months, 5-year overall survival (OS) and progression-free survival (PFS) rates were both 77.8%, with 8 patients in sustained CR and one progression. No treatment-related deaths occurred; grade ≥3 adverse events were rare (2 neutropenia, 2 anemia, 1 gastrointestinal bleeding).</p><p><strong>Conclusion: </strong>In this small pilot cohort, IRM showed promising activity and tolerability as first-line therapy for PCNS DLBCL. These descriptive findings warrant confirmation in larger prospective trials (#ChiCTR1900027811).</p>","PeriodicalId":12482,"journal":{"name":"Frontiers in Oncology","volume":"15 ","pages":"1669385"},"PeriodicalIF":3.5,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12527878/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145328739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Report: Primary breast leiomyosarcoma in an 84-year-old male.","authors":"Jie Yang, Wei Liu, Jie An, Cheng Jiao, Zhi Li, Shuai Qi, Chen Hao, Yao Zhang, Hui-Lin Wang, Jun Guo","doi":"10.3389/fonc.2025.1660377","DOIUrl":"10.3389/fonc.2025.1660377","url":null,"abstract":"<p><p>Primary breast leiomyosarcoma is an extremely rare malignancy originating from mesenchymal tissue. Fewer than 10 male cases have been reported globally. This paper reports an 84-year-old male patient. This represents the oldest reported case in the current literature. A painless, slowly enlarging mass was present in his right breast. The mass had a 10-year history. This contrasts sharply with the typically rapidly progressive pattern documented in previous literature. Clinical examination revealed a mobile mass measuring 12 cm × 10 cm in the right breast. No lymphadenopathy was detected. Ultrasound showed a hypoechoic lesion classified as BI-RADS 4a. Magnetic resonance imaging demonstrated plateau-type enhancement. The patient underwent simple mastectomy. Axillary lymph node dissection was not performed. Postoperative pathology and immunohistochemistry confirmed the diagnosis of breast leiomyosarcoma. The patient declined adjuvant radiotherapy. Follow-up at 6 months postoperatively showed no local recurrence or metastasis. This case indicates several points to clinicians. Immunohistochemistry serves as the cornerstone for diagnosing spindle cell tumors of the breast. R0 surgical resection constitutes the core approach for achieving cure. Decisions regarding adjuvant therapy require full consideration of host age and tumor biological behavior. The senescent microenvironment in elderly patients may suppress aggressive tumor progression.</p>","PeriodicalId":12482,"journal":{"name":"Frontiers in Oncology","volume":"15 ","pages":"1660377"},"PeriodicalIF":3.5,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12527855/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145328706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mapping the relationship between obesity and endometrial cancer: current research hotspots and future trends (2003-2024).","authors":"Lei Liang, Chuangxiu Song, Bo Yang, Chun Chang, Shichao Chen, Li Sun","doi":"10.3389/fonc.2025.1567022","DOIUrl":"10.3389/fonc.2025.1567022","url":null,"abstract":"<p><strong>Background: </strong>Obesity is an independent risk factor for endometrial cancer (EC). Bibliometrics allows for the analysis of multiple data from published publications to identify the current state of research and future trends and to construct a knowledge framework. There is a lack of high-quality bibliometric analyses of obesity and EC.</p><p><strong>Methods: </strong>This study retrieved publications related to obesity and EC from the Web of Science Core Collection (WOSCC) from 2003 to 2024. Publication trends were analyzed using Microsoft Excel 2019, while CiteSpace (v.6.4.R1 Advanced) was employed to analyze institutional co-occurrence, cited journals, journal co-citation mapping, co-cited references, and keywords. VOSviewer (v.1.6.20) was used to analyze the journals in which the publications appeared. SCImago Graphica (v.1.0.39) was utilized to investigate the distribution and collaboration of countries/regions, institutional collaborations, and author collaborations.</p><p><strong>Results: </strong>681 publications from 2003 to 2024 were included in the final analysis. The volume of publications showed an upward trend, peaking in 2021. The United States was the country with the highest number of publications, with the National Cancer Institute (NCI) being the leading institution. Scholars Emma J. Crosbie and Faina Linkov had the highest publication counts, while CALLE EE was the most cited scholar. The journal Gynecologic Oncology (Q1/4.5) published the most relevant articles and was also the most frequently cited journal. The most common keywords were \"endometrial cancer,\" \"body mass index,\" and \"risk.\" Current research focuses on exploring the mechanisms linking obesity and EC and analyzing the impact of obesity on clinical treatment strategies for EC. Future research directions include: (1) expanding the scope to related diseases of EC; (2) emphasizing typical indicators and diagnostic techniques for EC; (3) developing new treatment methods and technologies to enhance clinical efficacy; and (4) further strengthening the exploration of the pathological mechanisms related to obesity and EC.</p><p><strong>Conclusion: </strong>This study comprehensively summarizes the knowledge structure of obesity and EC and identifies key research hotspots and trends. Based on our findings, the formation of a multidisciplinary team, the rational application of diagnostic and therapeutic techniques, the further enhancement of the exploration of the pathological mechanisms associated with obesity and EC as well as the improvement of clinical diagnostic and therapeutic strategies are powerful measures to promote the development of this field.</p>","PeriodicalId":12482,"journal":{"name":"Frontiers in Oncology","volume":"15 ","pages":"1567022"},"PeriodicalIF":3.5,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12527895/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145328270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pathologic complete response of advanced hepatoid adenocarcinoma of the stomach following immuno-chemotherapy and conversion surgery: a rare case report and review of the literature.","authors":"Yaoqi Li, You Wang, Tao Yu, Dong Wang, Hong Ma, Jichun Ma, Mingxu Da","doi":"10.3389/fonc.2025.1648766","DOIUrl":"10.3389/fonc.2025.1648766","url":null,"abstract":"<p><strong>Background: </strong>Hepatoid adenocarcinoma of the stomach (HAS) is a rare subtype of gastric cancer (GC) characterized by alpha-fetoprotein (AFP) production and invasive liver and lymph node metastases, typically associated with a poor prognosis. Although immuno-chemotherapy has made significant achievements in the conversion therapy of advanced GC in recent years, the management of HER2-negative, proficient mismatch repair (pMMR), and a programmed cell death ligand-1 (PD-L1) combined positive score (CPS)<5 cases, particularly in the context of synchronous multiple liver metastases and lymph node involvement, poses significant challenges. This is attributable not only to its rapid progression but also to its poor prognosis. We retrospectively report a case of HAS with concurrent multiple liver and lymph node metastases. Following six cycles of immuno-chemotherapy, R0 resection was achieved, and postoperative pathological examination confirmed a pathological complete response (pCR). No recurrence or metastasis was observed at the 32-month postoperative follow-up (last follow-up: April 26, 2025). To our knowledge, no previous reports have documented pCR in HER2-negative, pMMR, and PD-L1 CPS<5 patients with advanced HAS following conversion therapy with combined immuno-chemotherapy. This report aims to provide further clinical reference for the treatment of advanced HAS.</p><p><strong>Case summary: </strong>A 51-year-old male patient was diagnosed with HAS accompanied by multiple liver and lymph node metastases. Following six cycles of immunotherapy (sintilimab) combined with chemotherapy (Nab-paclitaxel, oxaliplatin, and S-1), the primary tumor exhibited significant reduction. Multiple liver metastases showed partial shrinkage or disappearance (the target lesion diameter must be less than 10 mm), and retroperitoneal lymph nodes were no longer detectable. After thorough evaluation, R0 resection was deemed achievable. Therefore, radical distal gastrectomy with D2 lymphadenectomy and liver metastasectomy were performed. Postoperative pathology confirmed pCR. The patient has remained progression-free survival (PFS) for 32 months and overall survival (OS) for 38 months, with no evidence of recurrence or metastasis.</p><p><strong>Conclusion: </strong>HAS is a highly invasive malignant tumor of the stomach. The dynamic changes in AFP serve as a reliable indicator for detecting HAS, evaluating treatment efficacy, and predicting recurrence. In advanced HER-2-negative, PD-L1 CPS<5, pMMR-type HAS, employing a conversion therapy regimen combining sintilimab with Nab-paclitaxel, oxaliplatin, and S-1 may reduce tumor staging, enhance conversion therapy success rates, and prolong survival.</p>","PeriodicalId":12482,"journal":{"name":"Frontiers in Oncology","volume":"15 ","pages":"1648766"},"PeriodicalIF":3.5,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12527888/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145328572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CT-based radiomics and deep learning to predict EGFR mutation status in lung adenocarcinoma.","authors":"Xingzhi Jiang, Qian Sun, Can Wang, Wei Li, Wang Chen, Juan Xu, Lei Yu","doi":"10.3389/fonc.2025.1597548","DOIUrl":"10.3389/fonc.2025.1597548","url":null,"abstract":"<p><strong>Objectives: </strong>Epidermal growth factor receptor (EGFR) mutation status is an essential biomarker guiding targeted therapy selection in lung adenocarcinoma. This study aimed to develop and validate a non-invasive predictive model that integrates radiomics and deep learning using CT images for accurate assessment of EGFR mutation status.</p><p><strong>Methods: </strong>A total of 220 patients with lung adenocarcinoma were retrospectively enrolled and randomly divided into training and testing cohorts at a 7:3 ratio. Radiomics features were extracted from CT images using PyRadiomics, and deep learning features were obtained from five pretrained architectures: ResNet34, ResNet152, DenseNet121, ShuffleNet, and Vision Transformer (ViT). Feature selection used the intraclass correlation coefficient, Spearman correlation, and LASSO regression. The deep learning architectures were compared within the training set using cross-validation, and the best-performing architecture, ViT, was retained for downstream modeling. Based on the selected features, we constructed a radiomics model (Rad model), a ViT-based deep learning model (ViT model), and two fusion models (early fusion and late fusion) integrating radiomics and ViT features. Model performance was evaluated using receiver operating characteristic (ROC) curves, area under the curve (AUC), accuracy, sensitivity, specificity, precision, F1-score, and decision curve analysis (DCA).</p><p><strong>Results: </strong>The fusion models outperformed both radiomics and deep learning models in predicting EGFR mutation status. In the testing set, the early fusion model achieved the highest predictive performance (AUC = 0.910), exceeding the late fusion model (AUC = 0.892), the ViT model (AUC = 0.870), and the Rad model (AUC = 0.792). It also demonstrated superior accuracy (0.848), sensitivity (0.872), and specificity (0.815). Decision curve analysis further confirmed its clinical utility.</p><p><strong>Conclusion: </strong>Our study demonstrated that integrating radiomics and deep learning contributed to EGFR mutation prediction, providing a non-invasive approach to support personalized treatment decisions in lung adenocarcinoma.</p>","PeriodicalId":12482,"journal":{"name":"Frontiers in Oncology","volume":"15 ","pages":"1597548"},"PeriodicalIF":3.5,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12527853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145328644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}