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A Multidisciplinary Consensus-Building Exercise to Define and Prioritize Topics in Supportive Care of Children With Cancer at a Global Level 开展多学科共识建设活动,在全球范围内确定癌症患儿支持性护理的主题和优先顺序。
IF 2.9 2区 医学
Cancer Medicine Pub Date : 2024-11-05 DOI: 10.1002/cam4.70377
Elizabeth Sniderman, Tea Reljic, Manoo Bhakta, Miguel Bonilla, Julie Clyce, Jessica Farmer, Monica Key, Sergio Licona, Jennifer L. Pauley, Alondra Torres-Gonzalez, Michael Sullivan, Nickhill Bhakta, Ambuj Kumar, Sheena Mukkada
{"title":"A Multidisciplinary Consensus-Building Exercise to Define and Prioritize Topics in Supportive Care of Children With Cancer at a Global Level","authors":"Elizabeth Sniderman,&nbsp;Tea Reljic,&nbsp;Manoo Bhakta,&nbsp;Miguel Bonilla,&nbsp;Julie Clyce,&nbsp;Jessica Farmer,&nbsp;Monica Key,&nbsp;Sergio Licona,&nbsp;Jennifer L. Pauley,&nbsp;Alondra Torres-Gonzalez,&nbsp;Michael Sullivan,&nbsp;Nickhill Bhakta,&nbsp;Ambuj Kumar,&nbsp;Sheena Mukkada","doi":"10.1002/cam4.70377","DOIUrl":"10.1002/cam4.70377","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Optimal outcomes during childhood cancer treatment require effective management of toxicities, often called supportive care. A lack of agreement on what comprises supportive care limits the development and provision of comprehensive guidance (for this work, we have defined supportive care as any disease- or treatment-related condition experienced by children with cancer, excluding psychosocial conditions, palliative care, survivorship, or procedural topics). To address this gap, we conducted a consensus-building exercise among global experts to define and prioritize topics for supportive care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Two rounds of brainstorming and prioritization exercises were conducted. A multidisciplinary panel nominated by professional societies and cooperative groups was formed to ensure geographic and resource representation using snowball sampling. An internal expert panel generated an initial list of supportive care topics. In round one, the multidisciplinary panel reviewed the initial list and recommended additional topics, followed by prioritization in round two using a seven-point Likert scale. Results were summarized using descriptive statistics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The multidisciplinary panel consisted of 57 members representing 32 countries. The initial list included 46 topics; 161 additional topics were suggested. After removing duplicates and out-of-scope additions, the final list contained 62 topics. Febrile neutropenia, sepsis, bloodstream infections, and pain were ranked highest priority. Mortality, morbidity, and frequency of the event were identified as the most important factors influencing prioritization.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Through a multidisciplinary and globally representative process, we identified core supportive care topics and factors influencing their prioritization for childhood cancer. Outputs from this work will inform efforts to generate resource-adapted recommendations for a global audience. This supports ongoing WHO CureAll work to develop a health systems-level policy brief of supportive care requirements in the management of children with cancer.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"13 21","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.70377","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142581152","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}
引用次数: 0
Disease Characteristics and Outcomes of 493 Young Myeloma Patients Treated With Modern Therapies: A Canadian Myeloma Research Group Database Study 493名接受现代疗法治疗的年轻骨髓瘤患者的疾病特征和疗效:加拿大骨髓瘤研究小组数据库研究》。
IF 2.9 2区 医学
Cancer Medicine Pub Date : 2024-11-05 DOI: 10.1002/cam4.70332
Mégane Tanguay, Jean Roy, Jiandong Su, Engin Gul, Donna Reece, Christopher P. Venner, Darrell White, Michael P. Chu, Victor H. Jimenez-Zepada, Kevin Song, Arleigh Mccurdy, Hira Mian, Michael Sebag, Debra Bergstrom, Julie Stakiw, Anthony Reiman, Rami Kotb, Muhammad Aslam, Rayan Kaedbey, Martha Louzada, Richard LeBlanc
{"title":"Disease Characteristics and Outcomes of 493 Young Myeloma Patients Treated With Modern Therapies: A Canadian Myeloma Research Group Database Study","authors":"Mégane Tanguay,&nbsp;Jean Roy,&nbsp;Jiandong Su,&nbsp;Engin Gul,&nbsp;Donna Reece,&nbsp;Christopher P. Venner,&nbsp;Darrell White,&nbsp;Michael P. Chu,&nbsp;Victor H. Jimenez-Zepada,&nbsp;Kevin Song,&nbsp;Arleigh Mccurdy,&nbsp;Hira Mian,&nbsp;Michael Sebag,&nbsp;Debra Bergstrom,&nbsp;Julie Stakiw,&nbsp;Anthony Reiman,&nbsp;Rami Kotb,&nbsp;Muhammad Aslam,&nbsp;Rayan Kaedbey,&nbsp;Martha Louzada,&nbsp;Richard LeBlanc","doi":"10.1002/cam4.70332","DOIUrl":"10.1002/cam4.70332","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Young patients ≤ 50 years old with multiple myeloma (MM) account for about 10% of cases and are underrepresented in the literature.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We explored disease characteristics, treatments, and outcomes following modern therapies of young MM patients using the Canadian Myeloma Research Group (CMRG) database. We included 493 patients ≤ 50 years old diagnosed with MM or plasma cell leukemia without concurrent amyloidosis or POEMS syndrome from January 1, 2010, to July 1, 2022.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The median age was 46 years old (range: 25.6–50). Most patients fell into the R-ISS II category (72.7%), and 24.1% had high-risk cytogenetics. The majority of patients (89.9%) received a proteasome inhibitor-based first-line treatment, 92.1% received a stem cell transplant, and 65.6% had maintenance therapy post–autologous stem cell transplant (ASCT). Median follow-up from initial treatment to patients' last follow-up was 48.5 (range: 0–155) months. Median progression-free survival (PFS) was 45.0 months (95% CI: 40.2–50.0). Maintenance therapy post-ASCT improved median PFS to 52.3 months (95% CI: 43.1–68.2), compared to 23.6 months (95% CI: 20.0–34.8) without maintenance [<i>p</i> &lt; 0.001].</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Although the overall survival has not yet been reached in this young population, our reported median PFS of only 45 months highlights the urgent need to develop innovative treatments to induce more profound and durable responses.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"13 21","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.70332","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142581154","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}
引用次数: 0
Transarterial Infusion Chemotherapy and Embolization for Patients With Unresectable Advanced Cancer of Stomach or Gastroesophageal Junction: A Retrospective Study 经动脉灌注化疗和栓塞治疗胃或胃食管交界处不可切除的晚期癌症患者:回顾性研究
IF 2.9 2区 医学
Cancer Medicine Pub Date : 2024-11-05 DOI: 10.1002/cam4.70396
Lingqiang Min, Zheng Liu, Bo Zhou, Peng Zhou, Rongkui Luo, Yuqin Ding, Yuehong Cui, Zhongyi Shi, Yuan Gu, Yihong Sun, Zhaoqing Tang, Xuefei Wang
{"title":"Transarterial Infusion Chemotherapy and Embolization for Patients With Unresectable Advanced Cancer of Stomach or Gastroesophageal Junction: A Retrospective Study","authors":"Lingqiang Min,&nbsp;Zheng Liu,&nbsp;Bo Zhou,&nbsp;Peng Zhou,&nbsp;Rongkui Luo,&nbsp;Yuqin Ding,&nbsp;Yuehong Cui,&nbsp;Zhongyi Shi,&nbsp;Yuan Gu,&nbsp;Yihong Sun,&nbsp;Zhaoqing Tang,&nbsp;Xuefei Wang","doi":"10.1002/cam4.70396","DOIUrl":"10.1002/cam4.70396","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Purpose</h3>\u0000 \u0000 <p>The feasibility of transarterial infusion chemotherapy and embolization (TAICE) in the treatment of advanced gastric cancer remains unclear. This study explored the value of TAICE in patients with unresectable locally advanced or metastatic cancer of stomach or gastroesophageal junction (GEJ).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Patients with unresectable gastric cancer who received TAICE for tumor hemorrhage cessation were enrolled in this retrospective study. TAICE was performed using the Seldinger method. The tumor feeding artery was selected for infusion chemotherapy and then was embolized by microspheres or gelatin sponge. Patients involved in this study received one to four cycles TAICE with one to three drugs in the regimen. The possibility of surgery was evaluated after TAICE. Objective response rate (ORR), disease control rate (DCR), R0 resection rate, pathological complete remission (pCR) rate, major pathological remission (MPR) rate, progression-free survival (PFS), overall survival (OS), and safety were analyzed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Between January 2015 and December 2020, a total of 27 patients received a median of 2 (range, 1–4) cycles of TAICE. ORR and DCR were 33.3% and 74.0%, respectively. Eighteen patients received surgery, and 15 of them underwent gastrectomy and D2 lymph node dissection, with an R0 resection rate of 83.3% (15/18). Four (26.7%, 4/15) patients achieved MPR, but none achieved pCR. The median PFS was 19.8 months (95%CI, 12.1–40.0), and the median OS was 36.1 months (95%CI, 21.0–not reached). Patients with gastrectomy had significantly longer PFS (40.0 vs. 9.5 months, <i>p</i> &lt; 0.0001) and OS (not reached vs. 16.6 months, <i>p</i> &lt; 0.0001) than those without gastrectomy. All the TAICE-related adverse events were manageable, with the most common being fatigue (100%), nausea (63.0%), and vomiting (55.6%). No severe surgical complications occurred.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>TAICE was well-tolerated and could be a potential therapy to provide opportunity of surgery for patients with unresectable advanced gastric or GEJ cancer.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"13 21","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.70396","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142581204","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}
引用次数: 0
The Combined Inhibition of SREBP and mTORC1 Signaling Synergistically Inhibits B-Cell Lymphoma 联合抑制 SREBP 和 mTORC1 信号可协同抑制 B 细胞淋巴瘤。
IF 2.9 2区 医学
Cancer Medicine Pub Date : 2024-11-05 DOI: 10.1002/cam4.70342
Zhenhan Zhu, Wenxia Jiang, Jiehao Zhou, Alexander Robert Maldeney, Jingru Liang, Jing Yang, Wei Luo
{"title":"The Combined Inhibition of SREBP and mTORC1 Signaling Synergistically Inhibits B-Cell Lymphoma","authors":"Zhenhan Zhu,&nbsp;Wenxia Jiang,&nbsp;Jiehao Zhou,&nbsp;Alexander Robert Maldeney,&nbsp;Jingru Liang,&nbsp;Jing Yang,&nbsp;Wei Luo","doi":"10.1002/cam4.70342","DOIUrl":"10.1002/cam4.70342","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The sterol regulatory element-binding protein (SREBP) pathway is essential for maintaining sterol homeostasis during B cell activation and germinal center B cell proliferation. However, its potential as a therapeutic target to treat B-cell lymphoma remains unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We examined SREBP protein expression in human B-cell lymphoma samples using immunohistochemistry. Additionally, we conducted in vitro studies using SREBP signaling inhibitors in combination with rapamycin to assess their effects on cell proliferation and lipid metabolism in B-cell lymphoma cells.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Our analysis revealed high levels of SREBP2 protein expression in human B-cell lymphoma samples. Inhibiting SREBP signaling or its downstream target HMG-CoA reductase (HMGCR) with Fatostatin or Simvastatin effectively suppressed B-cell lymphoma cell proliferation. However, B-cell lymphoma cells responded to statin treatment by activating the mTORC1-pS6 pathway, suggesting a compensatory mechanism to overcome statin-induced cell cycle arrest. Combining low-dose statin treatment with the mTOR inhibitor rapamycin produced a synergistic effect, significantly inhibiting B-cell lymphoma proliferation, cell cycle progression, and lipid raft formation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>These results highlight the potential of a combined therapeutic approach targeting both SREBP and mTORC1 as a novel strategy for treating B-cell lymphoma.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"13 21","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11538279/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142581201","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}
引用次数: 0
Evaluation of the Prognostic Value of the Mayo Additive Staging System and Minimal Residual Disease in Newly Diagnosed Multiple Myeloma Patients 新诊断多发性骨髓瘤患者的梅奥添加分期系统和最小残留病灶的预后价值评估
IF 2.9 2区 医学
Cancer Medicine Pub Date : 2024-11-04 DOI: 10.1002/cam4.70382
Yichuan Song, Rui Zhao, Wenxuan Fu, Jing Zhao, Qingtao Wang, Rui Zhang
{"title":"Evaluation of the Prognostic Value of the Mayo Additive Staging System and Minimal Residual Disease in Newly Diagnosed Multiple Myeloma Patients","authors":"Yichuan Song,&nbsp;Rui Zhao,&nbsp;Wenxuan Fu,&nbsp;Jing Zhao,&nbsp;Qingtao Wang,&nbsp;Rui Zhang","doi":"10.1002/cam4.70382","DOIUrl":"10.1002/cam4.70382","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>This study aimed to evaluate the prognostic value of the Mayo additive staging system (MASS) and minimal residual disease (MRD) in newly diagnosed multiple myeloma (NDMM) patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 238 NDMM patients were enrolled in Beijing Chaoyang Hospital. Fluorescence in-situ hybridization and next-generation flow cytometry were used to examine cytogenetic abnormalities and MRD, respectively. The patients were classified into three groups to compare the effects on progression-free survival (PFS). Univariate and multivariate analyses were applied to identify the survival-related factors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>For MASS group, the PFS was significant difference in MASS I, II, and III patients (<i>p</i> = 0.0006); the patients with sustained MRD-negative, non-sustained MRD-negative, sustained MRD-positive, and non-sustained MRD-positive were divided into Groups 1, 2, 3, and 4, respectively. The Group 1 patients had superior PFS than Groups 2 and 3 patients (<i>p</i> &lt; 0.05), but no difference in PFS was observed for Group 2 versus Group 3, Group 2 versus Group 4, and Group 3 versus Group 4 patients. For the MASS and MRD groups, among Groups 2, 3, and 4, MASS I patients had a superior PFS, while III patients showed the opposite result. Strikingly, no difference in PFS for Group 1 patients regardless of the MASS stage was observed. Despite being in MASS II and III, the PFS of Group 1 patients was longer than those with the other three groups. Response to treatment was an independent prognostic factor for MM patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Patients with an accumulation of high-risk factors and MRD-positive have poor outcomes. Sustained MRD-negative may improve high-risk patients' prognoses.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"13 21","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.70382","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142566740","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}
引用次数: 0
Melanoma Metabolism: Molecular Mechanisms and Therapeutic Implications in Cutaneous Oncology 黑色素瘤代谢:皮肤肿瘤学的分子机制和治疗意义》。
IF 2.9 2区 医学
Cancer Medicine Pub Date : 2024-11-04 DOI: 10.1002/cam4.70386
Isabella J. Tan, Aarushi K. Parikh, Bernard A. Cohen
{"title":"Melanoma Metabolism: Molecular Mechanisms and Therapeutic Implications in Cutaneous Oncology","authors":"Isabella J. Tan,&nbsp;Aarushi K. Parikh,&nbsp;Bernard A. Cohen","doi":"10.1002/cam4.70386","DOIUrl":"10.1002/cam4.70386","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Melanoma, a highly aggressive skin cancer, is characterized by rapid progression and a high metastatic potential, presenting significant challenges in clinical oncology. A critical aspect of melanoma biology is its metabolic reprogramming, which supports tumor growth, survival, and therapeutic resistance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This review aims to explore the key molecular mechanisms driving metabolic alterations in melanoma and their implications for developing therapeutic strategies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A Pubmed search was conducted to analyze literature discussing key mechanisms of the Warburg effect, mitochondrial dysfunction, enhanced lipid metabolism, epigenetic modifications, and the tumor microenvironment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Metabolic reprogramming supports melanoma growth, proliferation, and survival. Understanding these complex metabolic dynamics provides valuable insights for developing targeted therapeutic strategies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Potential therapeutic interventions aimed at disrupting melanoma metabolism highlight the promise of precision medicine in improving treatment outcomes in cutaneous oncology. By targeting metabolic vulnerabilities, novel treatment approaches could significantly enhance the clinical management and prognosis of melanoma.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"13 21","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.70386","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142566744","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}
引用次数: 0
Features and Differences in Core Symptom Clusters in Home-Based Hospice Patients With Advanced Cancer: A Network Analysis 居家安宁疗护晚期癌症患者核心症状群的特征与差异:网络分析。
IF 2.9 2区 医学
Cancer Medicine Pub Date : 2024-11-04 DOI: 10.1002/cam4.70370
Yitao Wei, Wan Cheng, Yuanfeng Lu, Zheng Zhu, Guiru Xu, Hong Wu, Shaowei Lin, Huimin Xiao
{"title":"Features and Differences in Core Symptom Clusters in Home-Based Hospice Patients With Advanced Cancer: A Network Analysis","authors":"Yitao Wei,&nbsp;Wan Cheng,&nbsp;Yuanfeng Lu,&nbsp;Zheng Zhu,&nbsp;Guiru Xu,&nbsp;Hong Wu,&nbsp;Shaowei Lin,&nbsp;Huimin Xiao","doi":"10.1002/cam4.70370","DOIUrl":"10.1002/cam4.70370","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Patients with terminal-stage cancer frequently experience multiple symptoms simultaneously. Little is known about how core symptom clusters differ in advanced-cancer patients with different survival expectancies receiving hospice care. To identify the core symptom clusters of hospice-care cancer patients with different survival expectancies and compare the features of their symptom networks.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this retrospective study, secondary data analysis was conducted. Records of 6946 patients with advanced cancer who received home-based hospice care service in a hospice center from April 2001 to December 2020 were collected and analyzed using network analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>This analysis included 6946 patients with advanced cancer receiving hospice care. In patients with survival expectancies of 0–6 months, loss of appetite was identified as the core symptom (rs = 4.03, rb = 5.21, rc = 2.63), and five symptom clusters were identified. Malnutrition was the core symptom in patients with survival expectancies of 6–12 months (rs = 2.83, rb = 2.43, rc = 0.93), and nine symptom clusters were identified. Wasting syndrome was the core symptom cluster in two groups. The network density of symptoms in patients with &lt; 6 months of survival expectancy (91.99) was higher than in patients with 6–12 months (28.39).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Nutrition impact symptoms are the core symptoms for home-hospice care cancer patients with a survival period of 1 year or below. Moreover, hospice cancer patients with short survival expectancies have greater inter-symptom impact.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"13 21","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.70370","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142566741","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}
引用次数: 0
Whether Primary Bone-Only Oligometastatic Nasopharyngeal Carcinoma Patients Benefit From Radiotherapy to the Bones on the Basis of Palliative Chemotherapy Plus Locoregional Radiotherapy?—A Large-Cohort Retrospective Study 在姑息化疗和局部放疗的基础上对骨骼进行放疗是否有利于原发性单纯骨转移鼻咽癌患者?
IF 2.9 2区 医学
Cancer Medicine Pub Date : 2024-11-04 DOI: 10.1002/cam4.70315
Wan-Ping Guo, Guo-Dong Jia, Si-Yi Xie, Xuan Yu, Xiao-Han Meng, Lin-Quan Tang, Xiao-Yun Li, Dong-Hua Luo
{"title":"Whether Primary Bone-Only Oligometastatic Nasopharyngeal Carcinoma Patients Benefit From Radiotherapy to the Bones on the Basis of Palliative Chemotherapy Plus Locoregional Radiotherapy?—A Large-Cohort Retrospective Study","authors":"Wan-Ping Guo,&nbsp;Guo-Dong Jia,&nbsp;Si-Yi Xie,&nbsp;Xuan Yu,&nbsp;Xiao-Han Meng,&nbsp;Lin-Quan Tang,&nbsp;Xiao-Yun Li,&nbsp;Dong-Hua Luo","doi":"10.1002/cam4.70315","DOIUrl":"10.1002/cam4.70315","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>Whether to perform local radiotherapy on metastatic bone for primary bone-only oligometastatic nasopharyngeal carcinoma (NPC) patients remains unclear. Therefore, we analyzed the treatment methods and their survival and developed a prognostic model to predict outcomes and guide personalized treatment.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>We studied 308 primary bone-only oligometastatic NPC patients who were treated with either palliative chemotherapy (PCT) alone, PCT combined with locoregional radiotherapy (LRRT), or PCT, LRRT, and radiotherapy to metastatic bones (bRT). The primary endpoint was overall survival (OS). Cox regression was utilized to identify independent prognostic factors, leading to the construction of a nomogram model. Patients were stratified into two risk groups based on median prognostic scores, and treatment modalities were compared using log-rank test while employing the inverse probability of treatment weighting (IPTW) to balance baseline characteristics and adjust for sample size differences between risk groups.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The best OS was observed in the group treated with PCT, LRRT, and bRT (HR = 0.60, 95% CI: 0.45–0.81, <i>p</i> = 0.002). Multivariable analysis revealed that age, N stage, pre-treatment levels of LDH, and EBV DNA were independent prognostic factors for OS. In total, 155 patients were in low-risk group while 153 were in high-risk group. Before and after IPTW, the high-risk group benefited from the PCT, LRRT, and bRT regimen (adjusted HR = 0.53, 95% CI: 0.42–0.67, <i>p</i> &lt; 0.001; unadjusted HR = 0.59, 95% CI: 0.42–0.83, <i>p</i> = 0.007), while the low-risk group did not (adjusted HR = 0.79, 95% CI: 0.56–1.11, <i>p</i> = 0.345; unadjusted HR = 0.65, 95% CI: 0.37–1.14, <i>p</i> = 0.309).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Best outcomes of the whole cohort were seen with PCT + LRRT + bRT. Our study identified age, N stage, pre-treatment LDH levels, and EBV DNA levels as independent prognostic factors for OS. The high-risk group demonstrated a longer OS when treated with PCT + LRRT + bRT, whereas the low-risk group did not benefit from the combinatorial treatment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"13 21","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.70315","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142566752","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}
引用次数: 0
Tissue-Resident Macrophages in Cancer: Friend or Foe? 癌症中的组织常驻巨噬细胞:是敌是友?
IF 2.9 2区 医学
Cancer Medicine Pub Date : 2024-11-04 DOI: 10.1002/cam4.70387
Jianhua Chi, Qinglei Gao, Dan Liu
{"title":"Tissue-Resident Macrophages in Cancer: Friend or Foe?","authors":"Jianhua Chi,&nbsp;Qinglei Gao,&nbsp;Dan Liu","doi":"10.1002/cam4.70387","DOIUrl":"10.1002/cam4.70387","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Macrophages are essential in maintaining homeostasis, combating infections, and influencing the process of various diseases, including cancer. Macrophages originate from diverse lineages: Notably, tissue-resident macrophages (TRMs) differ from hematopoietic stem cells and circulating monocyte-derived macrophages based on genetics, development, and function. Therefore, understanding the recruited and TRM populations is crucial for investigating disease processes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>By searching literature databses, we summarized recent relevant studies. Research has shown that tumor-associated macrophages (TAMs) of distinct origins accumulate in tumor microenvironment (TME), with TRM-derived TAMs closely resembling gene signatures of normal TRMs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Recent studies have revealed that TRMs play a crucial role in cancer progression. However, organ-specific effects complicate TRM investigations. Nonetheless, the precise involvement of TRMs in tumors is unclear. This review explores the multifaceted roles of TRMs in cancer, presenting insights into their origins, proliferation, the latest research methodologies, their impact across various tumor sites, their potential and strategies as therapeutic targets, interactions with other cells within the TME, and the internal heterogeneity of TRMs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>We believe that a comprehensive understanding of the multifaceted roles of TRMs will pave the way for targeted TRM therapies in the treatment of cancer.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"13 21","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.70387","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142566749","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}
引用次数: 0
An Integrated Nomogram Combining Deep Learning and Radiomics for Predicting Malignancy of Pulmonary Nodules Using CT-Derived Nodules and Adipose Tissue: A Multicenter Study 利用 CT 导出的结节和脂肪组织预测肺结节恶性程度的深度学习与放射组学相结合的综合提名图:一项多中心研究。
IF 2.9 2区 医学
Cancer Medicine Pub Date : 2024-11-04 DOI: 10.1002/cam4.70372
Shidi Miao, Qifan Xuan, Hanbing Xie, Yuyang Jiang, Mengzhuo Sun, Wenjuan Huang, Jing Li, Hongzhuo Qi, Ao Li, Qiujun Wang, Zengyao Liu, Ruitao Wang
{"title":"An Integrated Nomogram Combining Deep Learning and Radiomics for Predicting Malignancy of Pulmonary Nodules Using CT-Derived Nodules and Adipose Tissue: A Multicenter Study","authors":"Shidi Miao,&nbsp;Qifan Xuan,&nbsp;Hanbing Xie,&nbsp;Yuyang Jiang,&nbsp;Mengzhuo Sun,&nbsp;Wenjuan Huang,&nbsp;Jing Li,&nbsp;Hongzhuo Qi,&nbsp;Ao Li,&nbsp;Qiujun Wang,&nbsp;Zengyao Liu,&nbsp;Ruitao Wang","doi":"10.1002/cam4.70372","DOIUrl":"10.1002/cam4.70372","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Correctly distinguishing between benign and malignant pulmonary nodules can avoid unnecessary invasive procedures. This study aimed to construct a deep learning radiomics clinical nomogram (DLRCN) for predicting malignancy of pulmonary nodules.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>One thousand and ninety-eight patients with 6–30 mm pulmonary nodules who received histopathologic diagnosis at 3 centers were included and divided into a primary cohort (PC), an internal test cohort (I-T), and two external test cohorts (E-T1, E-T2). The DLRCN was built by integrating adipose tissue radiomics features, intranodular and perinodular deep learning features, and clinical characteristics for diagnosing malignancy of pulmonary nodules. The least absolute shrinkage and selection operator (LASSO) was used for feature selection. The performance of DLRCN was assessed with respect to its calibration curve, area under the curve (AUC), and decision curve analysis (DCA). Furthermore, we compared it with three radiologists. The net reclassification improvement (NRI), integrated discrimination improvement (IDI), and subgroup analysis were also taken into account.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The incorporation of adipose tissue radiomics features led to significant NRI and IDI (NRI = 1.028, <i>p</i> &lt; 0.05, IDI = 0.137, <i>p</i> &lt; 0.05). In the I-T, E-T1, and E-T2, the AUCs of DLRCN were 0.946 (95% CI: 0.936, 0.955), 0.948 (95% CI: 0.933, 0.963) and 0.962 (95% CI: 0.945, 0.979), The calibration curve revealed good predictive accuracy between the actual probability and predicted probability (<i>p</i> &gt; 0.05). DCA showed that the DLRCN was clinically useful. Under equal specificity, the sensitivity of DLRCN increased by 8.6% compared to radiologist assessments. The subgroup analysis conducted on adipose tissue radiomics features further demonstrated their supplementary value in determining the malignancy of pulmonary nodules.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The DLRCN demonstrated good performance in predicting the malignancy of pulmonary nodules, which was comparable to radiologist assessments. The adipose tissue radiomics features have notably enhanced the performance of DLRCN.</p>\u0000 </section>\u0000 </div>","PeriodicalId":139,"journal":{"name":"Cancer Medicine","volume":"13 21","pages":""},"PeriodicalIF":2.9,"publicationDate":"2024-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cam4.70372","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142566739","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}
引用次数: 0
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