Cancer Medicine最新文献

{"title":"Understanding Racial Disparities in Prostate Cancer: A Multifaceted Approach","authors":"Charles Cobbs IV,&nbsp;Gregory T. Chesnut,&nbsp;Ayesha A. Shafi","doi":"10.1002/cam4.70979","DOIUrl":"https://doi.org/10.1002/cam4.70979","url":null,"abstract":"<p>Prostate cancer (PCa) remains a significant public health challenge in the United States, disproportionately affecting African American (AA) men, who face higher incidence rates, more aggressive disease, and elevated mortality compared to Caucasian American (CA) men. This review explores the multifactorial underpinnings of these disparities, integrating genomic, socioeconomic, environmental, and systemic contributors. Genomic analyses reveal that AA men harbor distinct molecular alterations, including higher frequencies of FOXA1, BRAF, and CHD1 mutations, as well as DNA damage repair defects, highlighting the critical need for population-specific precision medicine. Immune-oncologic pathways and stromal interactions within the tumor microenvironment further underscore biological differences driving aggressive disease phenotypes. Concurrently, adverse social determinants—including limited access to care, lower PSA screening rates, delayed treatment, medical mistrust, and underrepresentation in clinical trials—contribute to poorer outcomes. Despite these challenges, evidence from equal-access healthcare systems indicates that when provided equitable treatment, AA men can achieve outcomes comparable to or better than their CA counterparts. This review emphasizes actionable strategies to reduce disparities, including increasing AA representation in clinical trials, enhancing culturally competent patient-provider communication, improving access to early detection and high-quality care, and expanding community-based outreach initiatives. A holistic, interdisciplinary approach is essential to dismantle systemic barriers and achieve health equity in prostate cancer outcomes.</p>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 11","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.70979","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144171942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cigarette Use, Lung Cancer Screening Eligibility and Completion Among Persons With Poor Mental Health","authors":"Monica Hernandez,&nbsp;Anastasia Rogova,&nbsp;Lorraine R. Reitzel,&nbsp;Lisa M. Lowenstein,&nbsp;Robert J. Volk","doi":"10.1002/cam4.70983","DOIUrl":"https://doi.org/10.1002/cam4.70983","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Depression and mental distress are associated with greater cigarette use; however, it remains unclear how poor mental health relates to eligibility and completion of lung cancer screening (LCS).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Study of a 2022 Behavioral Risk Factor Surveillance System (BRFSS) sample of adults aged 50+. Key mental health exposures for this paper were (i) any history of a depressive disorder, and (ii) frequent mental distress (FMD) in the last month. Descriptive analyses were conducted on all variables and ran separately on each mental health exposure to explore associations between mental health conditions, cigarette use, LCS eligibility, and completion.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Compared to adults without a depressive history, adults with a depressive history were more likely to currently smoke (19.9% vs. 10.8%); have a slightly higher average pack-year history (26.8 vs. 24.0 years); and were more likely to be eligible for LCS (18.9% vs. 10.8%). Among adults eligible for LCS, there was no difference in completion of screening in the last year between adults with versus without a depressive history (19.4% vs. 18.7%). A similar pattern of findings was observed for people with and without FMD.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Cigarette use is more common among persons with a history of depression or FMD, yet they are screened for lung cancer at similar rates compared to their counterparts without a history of depression or FMD. LCS rates are also low among persons with poor mental health, mirroring screening among general U.S. adults. Mechanisms to increase LCS rates among adults with mental health conditions are discussed.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 11","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.70983","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144171927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence, Risk and Trends of Multiple Primary Cancers in Patients With Colorectal Cancer: Evidence From the South Australian Cancer Registry","authors":"Mulugeta Melku,&nbsp;Oliver G. Best,&nbsp;Jean M. Winter,&nbsp;Lauren A. Thurgood,&nbsp;Muktar Ahmed,&nbsp;Ganessan Kichenadasse,&nbsp;Murthy Mittinty,&nbsp;Molla M. Wassie,&nbsp;Erin L. Symonds","doi":"10.1002/cam4.70984","DOIUrl":"https://doi.org/10.1002/cam4.70984","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Colorectal cancer (CRC) is the fourth most diagnosed cancer in Australia. With advancements in treatment and an increase in survival rates, CRC survivors face an elevated risk of developing multiple primary cancers (MPCs), presenting a clinical challenge. Therefore, this study aimed to estimate the incidence, trend and risk of MPCs after a diagnosis of CRC in the South Australian population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study analysed South Australian Cancer Registry data on individuals diagnosed with CRC as their first cancer from 1982 to 2017. The incidence of MPCs was assessed using cumulative incidence functions, and age-standardised rates were estimated. Poisson regression was used to determine the risk, and standardised incidence ratios (SIR) and absolute excess risks (AER) were estimated. Trends over time were analysed using Joinpoint regression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The study included 26,729 CRC survivors. Of the cohort, 15% (3917) developed 4453 MPCs, with 96% diagnosed six or more months after index CRC. The cumulative incidence of MPCs was 22.5% (95% CI: 21.6–23.4). The median follow-up time until MPC diagnosis was 6.4 years. Common MPCs included prostate (18.9%), subsequent CRC (13.1%), lung (10.8%), haematological (10.2%) and breast (8.0%) cancers. The overall risk of MPCs was higher in CRC survivors (SIR: 1.12, 95% CI: 1.09–1.16; AER: 22.6 per 10,000) compared to the incidence in the general South Australian population. The incidence of MPCs has increased over time (annual percentage change = 1.95, 95% CI: 1.33–2.51).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>CRC survivors are at increased risk of subsequent cancers, highlighting the need for targeted surveillance, particularly for prostate, lung, breast and blood cancers, for early detection and treatment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 11","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.70984","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144171928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gene Expression Analysis of (Paired) Primary and Relapsed Wilms Tumor Samples to Unravel the Underlying Factors Driving Tumor Recurrence","authors":"Alissa Groenendijk,&nbsp;Jarno Drost,&nbsp;Annelies M. C. Mavinkurve-Groothuis,&nbsp;Martine van Grotel,&nbsp;Geert O. Janssens,&nbsp;Annemieke S. Littooij,&nbsp;Alida F. W. van der Steeg,&nbsp;Marry M. van den Heuvel-Eibrink,&nbsp;Lennart Kester,&nbsp;Ronald R. de Krijger","doi":"10.1002/cam4.70969","DOIUrl":"https://doi.org/10.1002/cam4.70969","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>We aimed to unravel underlying factors driving Wilms tumor (WT) recurrence and to build a prediction model for recurrence based on gene expression data of (paired) primary and relapsed WT samples.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Experimental Design</h3>\u0000 \u0000 <p>Gene expression levels from seven paired primary and relapsed WT samples from patients treated in the Princess Máxima Center were compared among each other, as well as to matched primary WT samples of patients without recurrence (controls). The differential gene expression analysis results were run through ToppGene for functional enrichment. We built a 10-fold ridge regression model to predict relapse based on gene expression levels of the seven primary cases and all other available primary WT controls (<i>n</i> = 42).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The comparison of primary WT and paired relapses showed downregulation of genes involved in immune regulation among relapses and upregulation of cancer stem cell (CSC) regulation genes. Comparing these primary WT samples to matched controls, we observed that downregulated genes in primary samples of relapsed patients were related to stromal cells and muscle development, and upregulated genes were associated with CSCs. The prediction model revealed a sensitivity of 57.14% (95% CI: 14.29%–85.71%) and a specificity of 92.86% (95% CI: 83.33%–100%) when predicting WT relapse.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The CSC pool could play a role in relapse through immune regulation and tumor propagation. Differentiation of CSCs into mesenchymal cells might attenuate the risk of relapse. Our prediction model might aid in selecting patients with an increased risk of relapse at primary diagnosis when externally validated.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 11","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.70969","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144171678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fibrotic Fortresses and Therapeutic Frontiers: Pancreatic Stellate Cells and the Extracellular Matrix in Pancreatic Cancer","authors":"Sila Sigirli,&nbsp;Didem Karakas","doi":"10.1002/cam4.70788","DOIUrl":"https://doi.org/10.1002/cam4.70788","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Pancreatic ductal adenocarcinoma (PDAC) is characterized by a unique tumor microenvironment (TME) that plays pivotal roles in cancer progression, angiogenesis, metastasis, and drug resistance. This complex and dynamic ecosystem comprises cancer cells, stromal cells, and extracellular matrix (ECM) components, which interact synergistically to drive cancer aggressiveness. Among the stromal cells, cancer-associated fibroblasts (CAFs) and pancreatic stellate cells (PSCs), mainly accepted as a group of CAFs, are central players in shaping the desmoplastic, hypoxic, and immunosuppressive stroma of PDAC. PSCs, the most abundant stromal cells in PDAC, are resident pancreatic cells that undergo phenotypic changes upon activation, driving tumor progression through the secretion of cytokines, growth factors, ECM components (e.g., collagen, hyaluronic acid, fibronectin), and matrix metalloproteinases. In addition to cellular elements, ECM components significantly contribute to cancer aggressiveness by forming a physical barrier that hinders drug penetration, activating signaling pathways through specific receptor interactions, and generating peptides originating from the fragmentation of proteins to induce cancer migration. Regarding their critical roles in tumor progression, therapeutic approaches targeting PSCs and the ECM have garnered increasing interest in recent years. However, PSCs and stromal components may exhibit dual roles, with the potential to both promote and suppress tumor progression under different conditions. Therefore, targeting PSCs or stroma may lead to unintended outcomes, including exacerbation of cancer aggressiveness.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This review focuses on the multifaceted roles of PSCs in PDAC, particularly their interactions with cancer cells and their contributions to therapy resistance. Additionally, we discuss current and emerging therapeutic strategies targeting PSCs and the ECM components, including both preclinical and clinical efforts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>By synthesizing insights from recent literature, this review provides a comprehensive understanding of the role of PSCs in PDAC pathobiology and highlights potential therapeutic approaches targeting PSCs or ECM components to improve patient outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 11","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.70788","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144171199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Care Coordination for Mosunetuzumab Therapy in Patients With Follicular Lymphoma in Community Practices: Learnings From the MorningSun Study Investigators","authors":"Tara Graff,&nbsp;Ian Flinn,&nbsp;Jeff P. Sharman,&nbsp;Steven Liu,&nbsp;Bertrand M. Anz,&nbsp;Mitul Gandhi,&nbsp;Ayed Ayed,&nbsp;Richard Zuniga,&nbsp;Abdul Hai Mansoor,&nbsp;Lourenia M. Cassoli,&nbsp;Mei Wu,&nbsp;Prachi Jani,&nbsp;Juliana M. L. Biondo,&nbsp;Tony Lin,&nbsp;John M. Burke","doi":"10.1002/cam4.70936","DOIUrl":"https://doi.org/10.1002/cam4.70936","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Preliminary data from the MorningSun study have demonstrated that outpatient subcutaneous mosunetuzumab can be safely administered.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This publication describes how community centers in the MorningSun phase 2 study of outpatient subcutaneous mosunetuzumab in B-cell non-Hodgkin lymphomas prepared workflow and logistics (staff coordination, practice networks, and patient support) to monitor patients for cytokine release syndrome (CRS) and other toxicities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>Ten investigators at US community practice study sites (one rural, seven urban, and two rural/urban) were interviewed between January 12 and February 22, 2024. Interview transcripts were analyzed qualitatively to identify key themes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Prior to the study, 7/10 had limited/no experience administering bispecific antibodies for lymphoma. Regarding preparation before treatment, staff education was the most frequent need (7/10). All sites provided in-service training for staff involved with treatment administration. Most respondents (6/10) had multidisciplinary plans and agreed these eased logistical concerns. Out of hours, patients either called the triage team, a dedicated on-call number, the physician, or the emergency department. Most practices had preexisting relationships with hospitals for CRS management. All practices established methods for outpatient CRS monitoring; patient education and caregivers played important roles, and all respondents encouraged patients to use self-monitoring devices. Each community practice had different workflow and logistics based on their setting and infrastructure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Community practices can leverage other sites' experiences and adopt an individualized approach to implementing bispecific antibodies safely and efficiently. Designating a physician champion could provide a local resource to address staff questions and concerns.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 11","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.70936","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144148452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Circulating Tumor Cell Detection for Therapeutic and Prognostic Roles in Breast Cancer","authors":"Saiying Ma,&nbsp;Xiaojia Wang,&nbsp;Peter Ping Lin,&nbsp;Lei Lei","doi":"10.1002/cam4.70902","DOIUrl":"https://doi.org/10.1002/cam4.70902","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Circulating tumor cells (CTCs) are pivotal liquid biopsy (LB) biomarkers for breast cancer (BC), offering non-invasive insights into tumor progression and metastasis. Despite their clinical promise, CTC detection remains technically challenging due to their extreme rarity in peripheral blood.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This review systematically evaluates CTC detection methodologies, including immunoaffinity-based approaches and biophysical techniques, which exhibit inherent trade-offs in sensitivity, specificity, and compatibility with downstream analyses. Furthermore, post-isolation molecular characterization methods spanning genomic, transcriptomic, and proteomic analyses are also critically assessed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Key Findings</h3>\u0000 \u0000 <p>CTC molecular profiling holds significant clinical relevance, enabling early diagnosis, prognostic stratification, and real-time monitoring of therapeutic response. Baseline CTC counts or quantitative/phenotypic changes during treatment inform therapeutic decision-making, predict drug resistance, and correlate with recurrence risk and metastatic progression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Multimodal analysis integrating CTC morphology, surface markers, and molecular alterations advances precision therapy. However, standardization of detection platforms and clinical validation of CTC-guided protocols remain essential.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 11","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.70902","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144171179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"‘I Don't Think There Is a One-Size-Fits-All’: A Qualitative Study Exploring Healthcare Professional and Service Provider Perspectives of Using Innovative Models of Cervical Screening to Improve Equitable Access to Self-Collection","authors":"Claire Bavor,&nbsp;Tessa Saunders,&nbsp;Mikayla Wolfe,&nbsp;Megan A. Smith,&nbsp;Nicola Creagh,&nbsp;Deborah Bateson,&nbsp;Angela Kelly-Hanku,&nbsp;Paula Jops,&nbsp;Marion Saville,&nbsp;Natalie Taylor,&nbsp;Kate Broun,&nbsp;Julia M. L. Brotherton,&nbsp;Claire Nightingale","doi":"10.1002/cam4.70981","DOIUrl":"https://doi.org/10.1002/cam4.70981","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>In the Australian National Cervical Screening Program (NCSP), self-collection can be performed in any setting deemed appropriate by the healthcare professional who orders the test, creating opportunities to develop innovative cervical screening models that can address known barriers to access for under- and never-screened women and people with a cervix. This study explored the acceptability and appropriateness of innovative models and key considerations for their design and implementation from the perspectives of clinical and non-clinical providers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted online, semi-structured interviews with healthcare professionals, pathology providers and community service providers (June–October 2023). Data were analyzed using template analysis, a form of thematic analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There were 132 participants from across Australia (82 clinical providers [e.g., doctors, nurses, midwives]; 34 non-clinical providers [e.g., health/community service staff, disability support workers, bicultural workers]; and 16 pathology sector professionals). Four overarching themes were identified: acceptability, appropriateness, screening quality and safety, and implementation considerations. Most found innovative models acceptable when appropriately tailored to the needs of different population groups, particularly through community outreach, home in-reach and peer-supported services. Embedding clinical governance and oversight in the cervical screening pathway was a high priority to ensure that screening participants received adequate information about cervical screening and appropriate follow-up care. Participants identified the need for clearly defined roles in the cervical screening pathway, sustainable funding and professional development opportunities to expand the role of nurses and optimize the roles of non-clinical providers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Innovative models of cervical screening using self-collection can offer more accessible, inclusive, and convenient care, especially for under- and never-screened populations. Clinical governance and oversight must be embedded in the cervical screening pathway to maintain high-quality screening services and to support the implementation of tailored and targeted innovative screening models.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 11","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.70981","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144135659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SPARC Promotes Aerobic Glycolysis and 5-Fluorouracil Resistance in Colorectal Cancer Through the STAT3/HK2 Axis","authors":"Jingrong Xiang,&nbsp;Huan Zhang,&nbsp;Kanger Shen,&nbsp;Jie Feng,&nbsp;Kexi Yang,&nbsp;Tongguo Shi,&nbsp;Qinhua Xi","doi":"10.1002/cam4.70972","DOIUrl":"https://doi.org/10.1002/cam4.70972","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Chemotherapy has been used extensively in the clinic to treat colorectal cancer (CRC). Nevertheless, cancer cells usually develop chemoresistance under chemotherapy stress, leading to treatment failure. At present, the mechanism of chemoresistance in patients with CRC is not fully understood.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Firstly, Secreted protein acidic and rich in cysteine (SPARC) expression and prognosis in CRC clinical samples were investigated using tissue microarray (TMAs) and GEPIA databases. Subsequently in vitro, SPARC knockdown or overexpression was used to explore the role of SPARC in 5-fluorouracil (5-FU) resistance in CRC cell lines. Western blot or RT-qPCR was used to analyze the downstream molecules and pathways regulated by SPARC. The contents of glucose and lactic acid were determined by Elisa. In vivo a xenograft tumor model was constructed to verify the function of SPARC in 5-FU chemoresistance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>This study revealed a correlation between 5-FU resistance in CRC and the expression of SPARC. The elevated SPARC expression in CRC tissues was linked to a poor prognosis for CRC patients. SPARC knockdown in CRC cells significantly suppressed aerobic glycolysis and 5-FU resistance, whereas SPARC overexpression had cancer-promoting effects. Additionally, SPARC increased 5-FU resistance through the Signal transducer and activator of transcription 3 (STAT3)/Hexokinase-2 (HK2) pathway. The impact of SPARC on 5-FU resistance was eliminated both in vitro and in vivo by blocking HK2 or STAT3 signaling.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our results confirmed that SPARC affects the chemoresistance of CRC to 5-FU through the STAT3/HK2 axis and is one of the indispensable factors affecting the development of 5-FU resistance in CRC.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 11","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.70972","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144135658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PUF60-Regulated Isoform Switching of MAZ Modulates Gastric Cancer Cell Migration","authors":"Dong Xing,&nbsp;Ting Zhao,&nbsp;Chenchen Mao,&nbsp;Zheng Han,&nbsp;Wanxia Cai,&nbsp;Teming Zhang,&nbsp;Dianfeng Mei,&nbsp;Wangkai Xie,&nbsp;Jiaye Yu,&nbsp;Zhonghan Wu,&nbsp;Zhiyuan Chen,&nbsp;Shiyu Feng,&nbsp;Xian Shen,&nbsp;Xiangyang Xue,&nbsp;Dan Xiang","doi":"10.1002/cam4.70977","DOIUrl":"https://doi.org/10.1002/cam4.70977","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>As an essential transcription factor, Myc-associated zinc-finger protein (MAZ) is frequently upregulated in many human tumors and is a well-documented oncogene. However, we found high expression of MAZ was closely associated with good survival outcomes in patients with stomach adenocarcinoma (STAD), and the underlying mechanism involved remains to be elucidated. We hypothesize that alternative splicing of MAZ plays an important role.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Pan-cancer analysis of MAZ expression and prognostic significance was performed using The Cancer Genome Atlas (TCGA) data, with emphasis on its divergent prognostic impact in gastric cancer (GC). MAZ protein levels were further validated in 356 GC tissue samples via immunohistochemistry. Functional investigations encompassed MAZ knockout (KO) and isoform-specific rescue experiments to assess GC cell migration, alongside quantification of MAZ alternative splicing rates (PSI). Additionally, RNA immunoprecipitation sequencing (RIP-seq) identified PUF60-mediated regulation of MAZ isoforms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>MAZ was upregulated in GC but served as an independent protective prognostic factor. MAZ-KO enhanced GC cell migration, while isoform-specific re-expression revealed divergent roles: MAZ-2 promoted migration, whereas MAZ-1 and MAZ-3 suppressed it. Notably, MAZ-2 is highly expressed in GC and is associated with poor survival prognosis of patients. Lower PSI values of MAZ-2 were detected in GC. MAZ transcripts were directly bound by PUF60. PUF60 knockdown caused MAZ splice isoform switch, thereby enhancing GC cell migration.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The prognostic difference of MAZ in GC stems from isoform-specific functional antagonism, with cell migration phenotypes governed by the MAZ-1/3 versus MAZ-2 ratio. Targeting MAZ alternative splicing, particularly via PUF60 modulation, represents a novel therapeutic strategy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 11","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.70977","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126000","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}