Cancer Medicine最新文献

{"title":"A 39-Year Nationwide Study of Uveal Melanoma in Taiwan","authors":"An-Ning Chao,&nbsp;Angel Chao,&nbsp;Wei-Yang Chang,&nbsp;Chun-Chieh Wang,&nbsp;Yueh-Ju Tsai,&nbsp;Kuan-Jen Chen,&nbsp;Yih-Shiou Hwang,&nbsp;Lan-Yan Yang","doi":"10.1002/cam4.70754","DOIUrl":"https://doi.org/10.1002/cam4.70754","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>To investigate the incidence, treatment strategies, and survival outcomes of adult patients with uveal melanoma (UM) in Taiwan over a 39-year period.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>We conducted a retrospective, nationwide population-based cohort study retrieving data from the Taiwan Cancer Registry and the National Death Registry of Health and Welfare Data Science Center database. By employing the International Classification of Diseases diagnostic codes, we identified patients who were diagnosed with UM between January 1980 and December 2018. We analyzed treatment information, as well as mortality data, to gain a comprehensive understanding of the incidence, patient characteristics, treatment patterns, and survival outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 314 patients (156 males and 158 females) were diagnosed with UM. The overall incidence rate was 0.36 (range: 0.30–0.42) per million persons, with a mean age at diagnosis of 52 years. In terms of treatment options, enucleation was performed on 122 patients (38.9%), whereas 108 (34.4%) received radiotherapy (RT). The remaining 84 (26.8%) patients underwent alternative treatments. The 5-year overall survival (OS) rate was 58.3%. Pairwise comparisons showed that the OS rates of patients who underwent RT <i>versus</i> surgery were similar. Two factors were associated with favorable OS outcomes: being under 50 years of age (<i>p</i> &lt; 0.001) and being a female (<i>p</i> = 0.04).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our real-world study encompassing a 39-year timeframe revealed a relatively low incidence of UM within the Taiwanese population. Patients under the age of 50, as well as females, demonstrated more favorable OS outcomes.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 8","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.70754","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143831396","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":"Performance of a Logistic Regression Model Using Paired miRNAs to Stratify Abnormal Mammograms for Benign Breast Lesions","authors":"Hideo Akiyama,&nbsp;Lora Barke,&nbsp;Therese B. Bevers,&nbsp;Suzanne J. Rose,&nbsp;Jennifer J. Hu,&nbsp;Kelly A. McAleese,&nbsp;Shellie S. Campos,&nbsp;Satoshi Kondou,&nbsp;Jun Atsumi,&nbsp;Thomas F. Soriano","doi":"10.1002/cam4.70767","DOIUrl":"https://doi.org/10.1002/cam4.70767","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Mammography is effective in reducing breast cancer mortality, but it has false positive results that cause subsequent interventions such as biopsy or interval repeat mammography. Thus, there is a clinical unmet need for accurate molecular classifiers that can reduce unnecessary additional imaging and/or invasive diagnostic procedures for low-risk women.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>We performed miRNA profiling on a prospectively collected serum specimen obtained from each of the 432 subjects who received an abnormal mammogram or imaging result and then selected 265 subjects for further analysis. The miRNA classifier, named EarlyGuard, was generated based on a novel logistic regression model using “paired miRNAs” where the two miRNAs of interest exhibit the same properties.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The classifier developed using the training set of 174 subjects enrolled at seven investigative sites resulted in a negative predictive value (NPV) and a sensitivity of 96.4% and 91.2%, respectively. The classifier was validated using the test set consisting of 91 subjects enrolled at three investigative sites, two of which were not included in the training set. The resulting NPV and sensitivity were estimated similarly to be 96.9% and 95.8%, respectively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Our miRNA classifier has produced promising results that could be used in conjunction with mammography or other imaging procedures to reduce unnecessary invasive diagnostic procedures for women who are unlikely to have a suspicious or worse result on a subsequent diagnostic biopsy. Additional studies will be conducted in larger cohorts to determine if the sensitivity of the classifier will be improved.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 8","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.70767","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143831327","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":"Microsatellite Instability in the Tumor Microenvironment: The Role of Inflammation and the Microbiome","authors":"Elizabeth Vargas-Castellanos,&nbsp;Andrés Rincón-Riveros","doi":"10.1002/cam4.70603","DOIUrl":"https://doi.org/10.1002/cam4.70603","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Microsatellite instability (MSI) is a hallmark of DNA mismatch repair (MMR) deficiency that leads to genomic instability and increased cancer risk. The tumor microenvironment (TME) significantly influences MSI-driven tumorigenesis, and emerging evidence points to a critical role of the microbiome in shaping this complex interplay.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This review comprehensively examines the existing literature on the intricate relationship between MSI, microbiome, and cancer development, with a particular focus on the impact of microbial dysbiosis on the TME.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>MSI-high tumors exhibited increased immune cell infiltration owing to the generation of neoantigens. However, immune evasion mechanisms such as PD-1/CTLA-4 upregulation limit the efficacy of immune checkpoint inhibitors (ICIs) in a subset of patients. Pathobionts, such as Fusobacterium nucleatum and Bacteroides fragilis, contribute to MSI through the production of genotoxins, further promoting inflammation and oxidative stress within the TME.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The microbiome profoundly affects MSI-driven tumorigenesis. Modulation of the gut microbiota through interventions such as fecal microbiota transplantation, probiotics, and dietary changes holds promise for improving ICI response rates. Further research into cancer pharmacomicrobiomics, investigating the interplay between microbial metabolites and anticancer therapies, is crucial for developing personalized treatment strategies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 8","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.70603","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143831103","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":"Prognostic Comparison of Complete vs. Incomplete Radiofrequency Ablation for Colorectal Liver Metastases: A Multicenter Prospective Study","authors":"Huilin Lu,&nbsp;Xuancheng Xie,&nbsp;Yulan Zeng,&nbsp;Xiangwen Xia,&nbsp;Xiangjun Dong,&nbsp;Futang Bu,&nbsp;Hongjie Fan,&nbsp;Shufeng Xu","doi":"10.1002/cam4.70735","DOIUrl":"https://doi.org/10.1002/cam4.70735","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Radiofrequency ablation (RFA) is a curative treatment for colorectal liver metastases (CLMs) in selected patients. NCCN guidelines recommend RFA for both unresectable and select resectable CLMs when complete ablation with adequate margins is feasible. While RFA can achieve oncologic outcomes comparable to surgery in well-selected patients, residual tumors are associated with a poorer prognosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To identify predictors of residual tumor after percutaneous RFA for CLMs and evaluate their impact on overall survival (OS) and new intrahepatic metastases (NIHM).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We prospectively included patients with CLMs who underwent percutaneous RFA from November 2019 to November 2022. Dynamic contrast-enhanced computed tomography assessed CLMs before and after RFA. Residual tumor was defined as active tumor visible immediately post-ablation or within 4–8 weeks, within 1 cm of the ablation zone. Data from three centers formed a developmental cohort, validated with patients from a fourth center. Cox regression and Kaplan–Meier analysis assessed local tumor progression-free survival (LTPFS), NIHM, and OS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 200 patients (mean age 61 years, 126 men) with 410 tumors, independent predictors of residual tumors included perivascular tumor location (odds ratio [OR] = 6.673), tumor size ≥ 20 mm (OR = 3.925), and minimal ablative margin (OR = 0.599). These factors also predicted LTPFS. NIHM was more frequent in the residual tumor group than in the complete RFA (cRFA) group (<i>p</i> = 0.002). Median OS was 45 months, shorter in the residual tumor group (30 vs. 48 months, <i>p</i> = 0.009). Patients with NIHM who received transarterial chemoembolization combined with hepatic arterial infusion chemotherapy had a median OS of 43 months, compared to 34 months with RFA alone (<i>p</i> = 0.039).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>A non-perivascular tumor location, tumor size &lt; 20 mm, and a sufficient ablation margin are essential for achieving complete RFA. Residual tumors are associated with increased NIHM and shorter OS.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 8","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.70735","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143831326","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":"HLA-DQB1*05:02: A Novel Genetic Marker for Susceptibility to Oral Cavity Squamous Cell Carcinoma","authors":"Shiang-Fu Huang,&nbsp;Huei-Tzu Chien,&nbsp;Chi-Kuang Young,&nbsp;Yun-Shien Lee,&nbsp;Chun-Ta Liao,&nbsp;Kai-Lun Cho,&nbsp;Ching-Han Chen,&nbsp;Angel Chao","doi":"10.1002/cam4.70876","DOIUrl":"https://doi.org/10.1002/cam4.70876","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Environmental exposure to carcinogens causes mucosal damage in the upper aerodigestive tract and can lead to cancers. The susceptibility to carcinogens varies between individuals. To identify susceptibility genes in head and neck cancers, we enrolled patients with early-onset disease and analyzed them by genome-wide association study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Materials</h3>\u0000 \u0000 <p>This case–control study included 54 young male patients with oral squamous cell carcinoma (OSCC) who were treated between March 1996 and December 2016, as well as 2400 healthy controls. A single nucleotide polymorphism (SNP) array was used to determine genetic loci that increase susceptibility to OSCC. In another validation cohort, sequencing-based typing (TBG Biotechnology Corp., Taipei, Taiwan) was used to determine the HLA-DQB1 genotype in another 100 OSCC patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We analyzed the allele frequencies of 664,994 autosomal SNPs in 54 OSCC cases. In a genome-wide association analysis, four SNPs on chromosomes 6, 7, 9, and 12 were significantly different between OSCC patients and controls (corrected <i>p</i> &lt; 1.0 × 10⁻⁶). HLA-DQB1 was closest to rs28451423 on chromosome 6. In the validation cohort, HLA-DQB1*05:02 in OSCC (18.5%) was significantly different from the normal population (7.0%) (<i>p</i> = 0.009). The influence of disease onset was independently significant after adjusting smoking, alcohol drinking, and areca-quid chewing (<i>p</i> = 0.015, OR: 3.922, 95% confidence interval: 1.311–11.734). Furthermore, HLA-DQB1*05:02 was associated with early-onset OSCC (<i>p</i> = 0.004).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>HLA-DQB1*05:02 increases individuals' risks of OSCC independent of environmental exposures, particularly in cases of early-onset OSCC. This study provides a genetic basis and disease marker for personalized prevention of OSCC.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 8","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.70876","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143831328","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":"Real-World Assessment of Trilaciclib for the Prevention of Chemoradiotherapy-Induced Myelosuppression in Esophageal Squamous Cell Carcinoma: A Propensity Score Matching Study","authors":"Jingze Yan,&nbsp;Zeyuan Liu,&nbsp;Hui Chen,&nbsp;Xinchen Sun,&nbsp;Xiaolin Ge,&nbsp;Xiaojie Xia","doi":"10.1002/cam4.70862","DOIUrl":"https://doi.org/10.1002/cam4.70862","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Chemoradiotherapy-induced myelosuppression (CIM) is the most common adverse event of esophageal cancer treatment, often necessitating reductions or delays in chemotherapy. Current treatments target specific blood cells, causing adverse effects. Trilaciclib, a novel CDK4/6 inhibitor with myeloprotective effects, has not yet been evaluated for its use in esophageal cancer treatment. We aimed to investigate the efficacy and safety of trilaciclib in preventing CIM.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Clinical data were retrospectively collected from 203 patients with esophageal cancer who underwent concurrent radiotherapy at the Department of Radiotherapy of Jiangsu Province People's Hospital between January 2022 and January 2024. Patients were divided into the trilaciclib group (34 patients) and control group (169 patients). Propensity score matching (PSM) was performed to balance the baseline characteristics, and the incidence of myelosuppression and adverse events was compared.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Following PSM, 34 patients were included in each group, with no significant differences in baseline characteristics. The trilaciclib group exhibited significantly higher leukocyte, neutrophil, hemoglobin, and platelet levels (<i>p</i> &lt; 0.05). The trilaciclib group exhibited a lower incidence of grade III–IV neutropenia and leukopenia, and none developed febrile neutropenia. Objective remission and disease control rates were comparable between the groups, with 1-year overall survival and progression-free survival rates of 82.0% and 73.4% in the trilaciclib group and 78.9% and 72.7% in the control group (not significant). The incidence of non-hematological toxic events was similar between the groups (<i>p</i> &gt; 0.05).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Trilaciclib prevented myelosuppression in patients with esophageal cancer undergoing concurrent chemoradiotherapy, demonstrating good safety and efficacy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 8","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.70862","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143831339","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":"Bortezomib, Mitoxantrone Hydrochloride Liposome, and Dexamethasone for Relapsed/Refractory Multiple Myeloma: A Multi-Center, Open-Label Phase I Trial","authors":"Ya-Lan Zhou,&nbsp;Jin-Qiao Zhang,&nbsp;Wei Wang,&nbsp;Li Bao,&nbsp;Bai-Jun Fang,&nbsp;Da Gao,&nbsp;Li-Ping Su,&nbsp;Wen-Ming Chen,&nbsp;Guang-Zhong Yang","doi":"10.1002/cam4.70890","DOIUrl":"https://doi.org/10.1002/cam4.70890","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Backgrounds</h3>\u0000 \u0000 <p>Mitoxantrone hydrochloride liposome (Lipo-MIT) has shown clinical benefits in various tumors. However, there is no prospective study evaluating its effectiveness and safety in relapsed/refractory multiple myeloma (RRMM). A phase I trial of bortezomib, Lipo-MIT, and dexamethasone (VMitD) with the primary endpoints being safety and efficacy was performed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Twenty subjects were enrolled this study, and the dose of Lipo-MIT was designed to be 12, 16, and 20 mg/m² at Day 1 combined with bortezomib and dexamethasone.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The most common grade 3/4 non-hematologic adverse event was pneumonia (20%). The most frequently observed grade 3/4 hematologic toxicity included thrombocytopenia (70%), neutropenia (55%), lymphopenia (30%), and anemia (10%). Fifteen subjects received at least one efficacy evaluation, including 60% (9/15) with a very good partial response (VGPR) or better, resulting in an overall response rate (ORR) of 86.7% (13/15).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This is the first report about the novel triplet regimen VMitD, including Lipo-MIT for RRMM, which was well tolerated and demonstrated efficacy. Further studies are required to assess the outcomes more accurately and to evaluate its effectiveness in comparison to other salvage regimens containing proteasome inhibitors and anthracyclines.</p>\u0000 \u0000 <p><b>Trial Registration:</b> ClinicalTrials.gov identifier: NCT05052970</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 8","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.70890","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143831397","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":"Immunohistochemical-Based Molecular Typing of ACRG Combined With Immune-Associated PD-L1 Expression Can Predict the Prognosis of Gastric Cancer","authors":"Fang Li,&nbsp;Huiyan Deng,&nbsp;Zeqing Hu,&nbsp;Zihao Chen,&nbsp;Huirui Zhang,&nbsp;Jiankun He,&nbsp;Xiaoxiao Wang,&nbsp;Yueping Liu","doi":"10.1002/cam4.70863","DOIUrl":"https://doi.org/10.1002/cam4.70863","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Gastric cancer (GC) is a molecularly heterogeneous disease with diverse clinical outcomes. Traditional classifications lack predictive accuracy, necessitating alternative molecular subtyping approaches for effective prognosis prediction. The Asian Cancer Research Group (ACRG) molecular subtypes, combined with immune-associated PD-L1 expression, offer a promising framework to predict patient outcomes and potentially guide treatment strategies in GC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This study retrospectively analyzed 1007 primary GC patients who underwent surgical resection between January 2017 and June 2019 at the Fourth Hospital of Hebei Medical University. Comprehensive immunohistochemical and fluorescent PCR-capillary electrophoresis analyses were conducted to determine ACRG molecular subtypes (microsatellite instability [MSI], microsatellite stability with epithelial–mesenchymal transition [MSS/EMT], MSS/TP53⁺, and MSS/TP53⁻) and PD-L1 expression. We assessed the relationship between these classifications and various clinicopathological parameters, including survival outcomes, using Cox regression and Kaplan–Meier analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The ACRG subtypes showed significant associations with clinicopathological features, including tumor invasion depth, Lauren classification, and HER2 status. The MSI subtype (6.7% of cases) was associated with higher PD-L1 positivity and a favorable prognosis, whereas the EMT subtype had the lowest 5-year survival rate (34.55%) and was predominantly linked to diffuse-type histology. PD-L1 positivity correlated with worse survival outcomes, with independent predictive value alongside ACRG subtypes (HR for PD-L1 = 1.759, <i>p</i> = 0.001; HR for ACRG = 5.144, <i>p</i> &lt; 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The combination of ACRG molecular subtyping and PD-L1 expression serves as an effective predictor of GC prognosis, facilitating tailored clinical decision-making. The ACRG-PD-L1 classification system offers a practical, cost-effective approach for routine clinical application, providing critical insight into GC heterogeneity. Further multicenter studies are needed to validate these findings and explore the impact of ACRG subtypes on therapy responses, particularly in immunotherapy settings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 7","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.70863","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143801709","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":"Bioinformatics Combined With Biological Experiments to Identify the Pathogenetic Link of Type 2 Diabetes for Breast Cancer","authors":"Xin Bao,&nbsp;Zhirui Zeng,&nbsp;Wenjing Tang,&nbsp;Dahuan Li,&nbsp;Xianrui Fan,&nbsp;Kang Chen,&nbsp;Yongkang Wang,&nbsp;Weijie Ai,&nbsp;Qian Yang,&nbsp;Shu Liu,&nbsp;Tengxiang Chen","doi":"10.1002/cam4.70759","DOIUrl":"https://doi.org/10.1002/cam4.70759","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Type 2 diabetes mellitus (T2DM) constitutes a significant risk factor for breast cancer (BC), with affected women exhibiting a two- to three-fold increased likelihood of developing BC. Furthermore, women diagnosed with both BC and T2DM tend to experience poorer prognoses and exhibit greater resistance to various treatments compared to their non-diabetic counterparts. Consequently, elucidating the comorbidities associated with T2DM and BC is instrumental in enhancing the diagnostic and therapeutic strategies for BC.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A series of bioinformatics methods including weighted gene co-expression network analysis (WGCNA), differentially expressed gene (DEG) analysis, machine learning, and single-cell sequencing analysis were used to identify the pathogenetic molecules of T2DM for BC. Biological experiments including CCK-8, colony formation, wound healing, transwell assay, immunohistochemistry, and immunofluorescence were performed to determine the molecule effect.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>By conducting WGCNA and DEG analysis on the profiles of T2DM (GSE25724 and GSE20966) and the TCGA cohort of BC, we identified a total of 27 common hub genes shared between T2DM and BC. These genes were significantly enriched in pathways related to cell differentiation, cellular developmental processes, focal adhesion, and the MAPK signaling pathway. Notably, among these 27 genes, <i>CCNB2</i>, <i>XRCC2</i>, and <i>CENPI</i> were associated with poor prognosis in BC. Moreover, single-cell RNA sequencing analysis revealed that <i>CCNB2</i>, <i>XRCC2</i>, and <i>CENPI</i> are enriched in cancer cells within BC tissues. Additionally, we observed that CCNB2, XRCC2, and CENPI were elevated in BC tissues provided by patients with a diabetes history and associated with KI67 expression. Hyperglycemia treatment elevated the expression levels of CCNB2, XRCC2, and CENPI in BC cells, which correlated with increased cell proliferation and mobility. Conversely, the knockdown of these genes partially mitigated the pro-proliferative and pro-migratory effects induced by hyperglycemia in BC cells.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Our findings suggested that CCNB2, XRCC2, and CENPI may serve as key pathogenic mediators linking T2DM and BC. Targeting these molecules could potentially attenuate the adverse impacts of T2DM on BC progression.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 7","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.70759","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143801716","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":"“We Were Still Left in the Back Field, Not Knowing”: Pediatric Cancer Patients and Parents Describe Obstacles to Prognostic Communication","authors":"Adriana Areizaga Ayala,&nbsp;Harmony Farner,&nbsp;Shoshana Mehler,&nbsp;Caroline Christianson,&nbsp;Tara M. Brinkman,&nbsp;Justin N. Baker,&nbsp;Pamela S. Hinds,&nbsp;Jennifer W. Mack,&nbsp;Erica C. Kaye","doi":"10.1002/cam4.70810","DOIUrl":"https://doi.org/10.1002/cam4.70810","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>Patient/parent perceptions of poor-quality prognostic disclosure have not been well described, and these data offer important lessons to shape clinical practice and communication skills training. In this study, we aimed to characterize patient/parent negative experiences with prognostic communication to inform future efforts to improve how clinicians disclose prognosis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Patients and Methods</h3>\u0000 \u0000 <p>Semistructured interviews were conducted with a purposeful sample of pediatric cancer patients (<i>n</i> = 25) and parents (<i>n</i> = 40) across different timepoints in the progressive illness course extending into bereavement. Interviews were audio-recorded, transcribed, and de-identified for rapid qualitative analysis, in which multiple analysts used a standardized episode summary template to extract raw data specific to patient/parent narratives about prognostic disclosure experiences. Analysts engaged independently and collaboratively as a team in reflexive memo writing to identify negative experiences with prognostic communication, followed by team discussion to generate concepts and synthesize those concepts into themes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>More than half of participants (59%) described negative experiences with prognostic disclosure, with parents highlighting distressing communication experiences more often than patients (parents: 32/40, 80% vs. patients: 6/25, 24%). Across patient/parent narratives, three main themes underpinned the perception of poor-quality prognostic communication: (1) insufficient information, (2) overwhelming or contradictory information, and (3) absence of person-centered connection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Many patients/parents perceived prognostic disclosure to be suboptimal and identified specific features underpinning poor-quality prognostic communication. These findings will inform future collaborative research with patients, parents, and multidisciplinary clinicians to codesign an intervention that individualizes prognostication to align with patient/parent preferences for receiving information and fostering connection.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"14 7","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.70810","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143801514","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}