Journal of Cancer Research and Clinical Oncology最新文献

{"title":"Relationship between programmed cell death ligand 1 expression and the number of biopsy specimens in advanced gastric cancer.","authors":"Taro Mizuno, Yukiya Narita, Yasunobu Ishizuka, Tomoki Sakakida, Kazunori Honda, Toshiki Masuishi, Hiroya Taniguchi, Shigenori Kadowaki, Masashi Ando, Masahiro Tajika, Kei Muro","doi":"10.1007/s00432-025-06255-1","DOIUrl":"10.1007/s00432-025-06255-1","url":null,"abstract":"<p><strong>Purpose: </strong>Programmed cell death ligand 1 (PD-L1) expression in advanced gastric cancer (AGC) exhibits spatial heterogeneity, which may lead to sampling bias during biopsies. Although multiple biopsies are believed to improve the accuracy of PD-L1 assessment, the optimal number of specimens remains uncertain. This study investigated the relationship between PD-L1 expression and biopsy specimen count in AGC.</p><p><strong>Methods: </strong>We retrospectively analyzed 110 patients with AGC who underwent first-line chemotherapy and had PD-L1 combined positive scores (CPS) assessed using the 28-8 pharmDx assay. Associations between CPS and biopsy specimen count were evaluated using chi-square or Fisher's exact test. In a subgroup of 70 human epidermal growth factor receptor 2 (HER2)-negative patients treated with first-line nivolumab plus chemotherapy, survival outcomes were analyzed based on CPS status.</p><p><strong>Results: </strong>PD-L1 CPS ≥ 5 was identified in 79 patients (71.8%). The proportion of patients with CPS ≥ 5 was significantly higher in those with ≥ 5 biopsy specimens than in those with ≤ 4 (77.5% vs. 56.7%, P = 0.03). This trend was even more pronounced in HER2-negative patients (83.6% vs. 54.5%, P < 0.01) and in those with macroscopic type 2 tumors (91.3% vs. 33.3%, P < 0.01). However, no significant differences in progression-free or overall survival were found based on CPS status, regardless of biopsy count.</p><p><strong>Conclusion: </strong>Obtaining at least five biopsy specimens enhances the detection of PD-L1 CPS ≥ 5, particularly in HER2-negative or well-circumscribed nodular AGC, potentially improving the accuracy of PD-L1 evaluation. Nevertheless, survival outcomes were unaffected, highlighting the limited predictive value of CPS.</p>","PeriodicalId":15118,"journal":{"name":"Journal of Cancer Research and Clinical Oncology","volume":"151 7","pages":"206"},"PeriodicalIF":2.7,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12238204/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Cannabidiol inhibits invasion and metastasis in colorectal cancer cells by reversing epithelial-mesenchymal transition through the Wnt/β-catenin signaling pathway.","authors":"PanFeng Feng, LongXun Zhu, Jing Jie, PengXiang Yang, Nan Sheng, XiangFan Chen, Xia Chen","doi":"10.1007/s00432-025-06252-4","DOIUrl":"10.1007/s00432-025-06252-4","url":null,"abstract":"","PeriodicalId":15118,"journal":{"name":"Journal of Cancer Research and Clinical Oncology","volume":"151 7","pages":"204"},"PeriodicalIF":2.7,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12229955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic literature review to identify prognostic factors of efficacy and safety outcomes of chimeric antigen receptor T-Cell therapies in diffuse large B-Cell lymphoma.","authors":"Julia K Schleifenbaum, Jan-Michel Heger, Jonas Jost, Umberto Rosato, Sybille Riou, Peter Borchmann, Stefan Walzer, Jörg Mahlich","doi":"10.1007/s00432-025-06249-z","DOIUrl":"10.1007/s00432-025-06249-z","url":null,"abstract":"<p><strong>Purpose: </strong>To identify and summarize clinical factors influencing the efficacy and safety outcomes of CAR-T cell therapies in patients with diffuse large B-cell lymphoma (DLBCL) through a systematic literature review.</p><p><strong>Methods: </strong>We performed a systematic literature review to identify factors impacting the efficacy and safety of CAR-T therapies in DLBCL. Articles were searched in PubMed, Cochrane, and EMBASE databases. Key outcomes, including progression-free survival (PFS), overall survival (OS), complete response rate (CRR), objective response rate (ORR), duration of response (DoR), best overall response (BOR), and safety measures (e.g., Immune Effector Cell-Associated Neurotoxicity Syndrome [ICANS], and Cytokine Release Syndrome [CRS]), were extracted according to PRISMA guidelines. A total of 712 articles were identified, with 185 selected for full-text screening. Ultimately, 79 articles met inclusion criteria. Exclusions were primarily due to the absence of relevant outcome data or publication type.</p><p><strong>Results: </strong>This review highlights several factors that may influence the efficacy and safety of CAR-T therapies in DLBCL, including Eastern Cooperative Oncology Group Performance Status (ECOG PS), International Prognostic Index (IPI) score, disease histology, Ann Arbor disease stage, and elevated LDH levels.</p><p><strong>Conclusion: </strong>The findings of this review can assist clinicians in refining treatment strategies and improving patient outcomes in DLBCL by incorporating these key influencing factors.</p>","PeriodicalId":15118,"journal":{"name":"Journal of Cancer Research and Clinical Oncology","volume":"151 7","pages":"203"},"PeriodicalIF":2.7,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12229961/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and efficacy of TACE combined with immune checkpoint inhibitors plus molecular targeted therapies in older adults with unresectable hepatocellular carcinoma.","authors":"Xin Hong, Jin-Tao Huang, Di Hu, Wen-Jie Zhou, Jian Shen, Xiao-Li Zhu","doi":"10.1007/s00432-025-06257-z","DOIUrl":"10.1007/s00432-025-06257-z","url":null,"abstract":"<p><strong>Objectives: </strong>To assess the efficacy and tolerability of transarterial chemoembolization (TACE) plus immune checkpoint inhibitors (ICIs) plus molecular targeted therapies (MTT) in elderly patients with hepatocellular carcinoma (HCC) (≥ 65 years).</p><p><strong>Methods: </strong>This retrospective, multicenter study enrolled treatment-naïve HCC patients undergoing TACE combined with ICIs and MTT at three Chinese medical centers from June 2019 to December 2023. The study's primary endpoint was overall survival (OS), with secondary endpoints being the objective response rate (ORR), disease control rate (DCR) per modified RECIST criteria, and adverse events (AEs). To minimize selection bias, propensity score matching (PSM) was utilized for the elderly and younger patient cohorts.</p><p><strong>Results: </strong>The study cohort comprised 317 patients, with a median OS of 30.8 months for the overall population. The elderly patients had comparable OS (median, 33.3 vs. 30.4 months, P = 0.219) than younger patients. The PSM cohort included 106 elderly patients and 106 younger patients. After PSM, the elderly patients also had similar OS compared with younger patients (median, 33.3 vs. 24.6 months, P = 0.141). Meanwhile, the elderly patients achieved a similar ORR and DCR (58.5% vs. 54.7%, P = 0.579; 90.1% vs. 85.8%, P = 0.287, respectively) versus younger patients. No obvious differences in grade 3/4 AEs were noted among the two groups, and no new safety concerns arose.</p><p><strong>Conclusions: </strong>Elderly patients (age ≥ 65 years) receiving TACE combined with ICIs and MTT showed similar trends in prognosis and safety profiles compared with younger patients.</p>","PeriodicalId":15118,"journal":{"name":"Journal of Cancer Research and Clinical Oncology","volume":"151 7","pages":"202"},"PeriodicalIF":2.7,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12226637/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144560215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of ⁶⁸Ga-FAPI-04 PET/CT with CECT in the evaluation of peritoneal metastases from gastrointestinal cancers and impact on clinical decision-making.","authors":"Yushan Zhou, Yaqin Zhao, Dandan Shuai, Xibiao Yang, Qiancheng Hu, Xiangbing Deng, Qianrui Li, Minggang Su","doi":"10.1007/s00432-025-06237-3","DOIUrl":"10.1007/s00432-025-06237-3","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the diagnostic accuracy of ⁶⁸Ga-FAPI-04 PET/CT for peritoneal metastasis in gastrointestinal cancers and to assess its impact on clinical decision-making, comparing to contrast-enhanced computed tomography (CECT).</p><p><strong>Methods: </strong>We retrospectively included consecutive patients with gastrointestinal cancers, admitted between April 2022 and October 2022, and underwent both ⁶⁸Ga-FAPI-04 PET/CT and CECT within two weeks. The reference standard was histopathology or imaging follow-up. We compared patient-level accuracy to detect peritoneal metastases and to measure peritoneal tumor burden between ⁶⁸Ga-FAPI-04 PET/CT and CECT. We assessed the impact of ⁶⁸Ga-FAPI-04 PET/CT on treatment through a simulated multidisciplinary tumor board.</p><p><strong>Results: </strong>We included 57 patients, among which, 34 (59.65%) had peritoneal metastasis. ⁶⁸Ga-FAPI-04 PET/CT showed superior sensitivity (97.06% vs. 64.71%) and specificity (95.65% vs. 78.26%) than CECT, as well as area under the curve (0.964 vs. 0.715, P < 0.001). Among patients with peritoneal metastasis, ⁶⁸Ga-FAPI-04 PET/CT revealed higher peritoneal tumor burden than CECT (peritoneal cancer index [PCI]-region: 6.5 vs. 1, P < 0.001). ⁶⁸Ga-FAPI-04 PET/CT findings led to changes of treatment in 17 (29.82%) patients, among which, nine (15.8%) patients had new findings related to peritoneum. The impact was deemed high in 10 (17.54%) patients, moderate in six (10.53%), and low in one (1.75%).</p><p><strong>Conclusions: </strong>⁶⁸Ga-FAPI-04 PET/CT has the potential to influence clinical decision-making in gastrointestinal cancers and has superior accuracy than CECT. Further studies are warranted to support routine use.</p>","PeriodicalId":15118,"journal":{"name":"Journal of Cancer Research and Clinical Oncology","volume":"151 7","pages":"201"},"PeriodicalIF":2.7,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12226647/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144560214","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Small cell lung cancer differentiation in patients with driver mutant non-small cell lung cancer: a single center experience.","authors":"Oğuzhan Yıldız, Melek Karakurt Eryılmaz, Ali Fuat Gürbüz, Bahattin Engin Kaya, Talat Aykut, Ömer Genç, Murat Araz, Mehmet Artaç","doi":"10.1007/s00432-025-06194-x","DOIUrl":"10.1007/s00432-025-06194-x","url":null,"abstract":"<p><strong>Introduction: </strong>In the treatment of metastatic non-small cell lung cancer (mNSCLC), targeted therapies are utilized in the presence of driver mutations. Tyrosine kinase inhibitors (TKIs) have contributed positively to survival outcomes in this patient group. In driver mutant mNSCLC patients, caution is warranted for the development of small cell lung cancer (SCLC) differentiation following progression under TKI therapy. SCLC is associated with an aggressive course and shorter survival. The cornerstone of SCLC treatment is conventional chemotherapy. In this study, we aimed to present the development of SCLC differentiation in driver mutant mNSCLC patients who received at least one line of TKI therapy as a single-center experience.</p><p><strong>Patients and methods: </strong>Between April 2013 and January 2024, the medical records of 144 patients diagnosed with mNSCLC and found to harbor driver mutations were retrospectively reviewed at Necmettin Erbakan University Faculty of Medicine Hospital, Oncology Clinic. All patients had received at least one line of TKI. The analysis included evaluation of driver mutations, treatments administered, and the rate of SCLC differentiation in this patient population.</p><p><strong>Results: </strong>A total of 144 patients were included in the study. Among them, 122 patients (84.9%) had an EGFR mutation, 21 patients (15.1%) had an ALK mutation, and 1 patient had a ROS1 mutation. TKI therapy was administered as first-line treatment in 50% of the patients, as second-line in 40.3%, and as third-line in 6.3%. Biopsies were performed in 22 out of 144 patients after disease progression. Of these, 21 biopsies were from patients with EGFR mutations, and 1 was from a patient with an ALK mutation. Biopsies were conducted after first-line therapy in 8 cases, after second-line therapy in 11 cases, and after third-line therapy in 3 cases. SCLC differentiation was observed in 3 out of 22 patients (13.6%), all of whom had EGFR mutations. Additionally, 2 of these 3 patients developed SCLC differentiation following first-line TKI therapy, while 1 developed it after second-line TKI therapy.</p><p><strong>Discussion: </strong>The rate of SCLC differentiation in NSCLC is generally low and is considered rare. It is estimated that the rate of SCLC differentiation in NSCLC ranges between 1% and 3%. In our clinic, when evaluating driver mutant mNSCLC patients who received at least one line of TKI therapy, SCLC differentiation was observed in 3 patients (13.6%). The limitations of our study include its retrospective nature and the small sample size. However, the findings suggest that SCLC differentiation is a potential occurrence in driver mutant mNSCLC patients treated with TKIs. Therefore, careful monitoring and the detection of possible differentiation are essential in the follow-up of these patients.</p>","PeriodicalId":15118,"journal":{"name":"Journal of Cancer Research and Clinical Oncology","volume":"151 7","pages":"199"},"PeriodicalIF":2.7,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12222397/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144553670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"L-arginine vs. L-glutamine oral suspensions for radiation-induced oral mucositis: a triple-blind randomized trial.","authors":"Fatma E A Hassanein, Christine Mikhail, Sarah Elkot, Asmaa Abou-Bakr","doi":"10.1007/s00432-025-06213-x","DOIUrl":"10.1007/s00432-025-06213-x","url":null,"abstract":"<p><strong>Purpose: </strong>Radiation-induced oral mucositis (RIOM) severely impacts patients with head and neck cancer (HNC) undergoing radiotherapy, often leading to pain and malnutrition. L-arginine and glutamine are immune-enhancing amino acids with potential benefits in wound healing and inflammation control. This study evaluated the efficacy of L-arginine versus L-glutamine oral suspensions in managing RIOM.</p><p><strong>Methods: </strong>In this triple-blind, randomized controlled trial, 69 HNC patients with RIOM were allocated to three groups (n = 23 each): Group I (L-arginine 5 g + maltodextrin 5 g), Group II (glutamine 5 g + maltodextrin 5 g), or Group III (maltodextrin 10 g). Outcomes, assessed at weeks 2, 5, and 7 of radiotherapy, included the WHO oral mucositis scale, Pain Visual Analogue Scale (Pain-VAS), body mass index (BMI), and Oral Health Impact Profile (OHIP-14) questionnaire.</p><p><strong>Results: </strong>By week 5, WHO scale scores differed significantly among groups (p < 0.001), with arginine and glutamine groups exhibiting lower mucositis severity than the maltodextrin group. Pain-VAS scores at weeks 5 and 7 were significantly lower in the arginine and glutamine groups compared to maltodextrin (p = 0.004 and p < 0.001, respectively). By 7th week of radiotherapy, BMI was significantly decreased in the maltodextrin group than in either the arginine (p = 0.028) or glutamine (p = 0.001) groups, indicative of treatment-mediated weight loss. In contrast, the BMI over time in the arginine (p = 0.87) and glutamine (p = 0.170) groups were almost constant. This indicates that compared to maltodextrin alone, both amino acid supplements prevented a decline in BMI during radiotherapy. OHIP-14 scores improved significantly in the arginine and glutamine groups at weeks 5 and 7 (p < 0.001), indicating better quality of life.</p><p><strong>Conclusions: </strong>Both L-arginine and glutamine significantly reduced RIOM severity, pain, and weight loss compared to maltodextrin, while improving quality of life in patients with head and neck cancer. Although no statistically significant difference was found between the two, a higher proportion of patients receiving L-arginine achieved complete healing by week 7, suggesting a potential late advantage. These findings support the use of both amino acids as viable options for symptom management during radiotherapy.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov (NCT06764420), registered 08/01/2024.</p>","PeriodicalId":15118,"journal":{"name":"Journal of Cancer Research and Clinical Oncology","volume":"151 7","pages":"198"},"PeriodicalIF":2.7,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12222376/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144553669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Conversion therapy and R0 resection for pancreatic cancer with multiple liver metastases: a case report.","authors":"Sifan Dong, Yunlong Gao, Zhe Wang, Jinqiang Liang, An Jiang","doi":"10.1007/s00432-025-06180-3","DOIUrl":"10.1007/s00432-025-06180-3","url":null,"abstract":"<p><strong>Background: </strong>Pancreatic cancer has a high degree of malignancy, poor prognosis, and short survival time. Surgical resection is the main treatment for pancreatic cancer, but the resection rate is only 20%. Liver metastases are the main reason of unresectable. The conversion therapy for pancreatic cancer with liver metastases is rare and less reported.</p><p><strong>Case presentation: </strong>A 52-year-old male patient with pancreatic cancer and multiple liver metastases was reported. Imaging examination showed multiple low-density shadows in the liver. Laboratory tests showed elevated levels of pro-gastrin-releasing peptide and CEA. After gemcitabine combined with albumin-bound paclitaxel chemotherapy, the liver metastases disappeared and the primary pancreatic head tumor was significantly reduced. Pancreaticoduodenectomy was performed, and the patient recovered well without any other adjuvant therapy. The patient has been alive for 36 months without tumor recurrence.</p><p><strong>Conclusions: </strong>The efficacy of Gemcitabine combined with Albumin-bound paclitaxel in conversion therapy for pancreatic cancer patients with multiple liver metastases may be related to the size and duration of metastases, which needs to be further studied.</p>","PeriodicalId":15118,"journal":{"name":"Journal of Cancer Research and Clinical Oncology","volume":"151 7","pages":"200"},"PeriodicalIF":2.7,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12226612/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144553668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiac autonomic dysfunction in patients with cancer: exploring the role of physical exercise.","authors":"Anita Borsati, Linda Toniolo, Christian Ciurnelli, Francesco Bettariga, Silvia Teresa Riva, Paolo Frada, Lorenzo Belluomini, Ilaria Trestini, Daniela Tregnago, Jessica Insolda, Marco Sposito, Federico Schena, Michele Milella, Robert U Newton, Sara Pilotto, Alice Avancini","doi":"10.1007/s00432-025-06234-6","DOIUrl":"10.1007/s00432-025-06234-6","url":null,"abstract":"<p><strong>Purpose: </strong>Cardiovascular diseases are a leading cause of non-cancer mortality among patients with cancer, with cardiac autonomic dysfunction identified as a significant predictor of future cardiovascular conditions. Despite the importance of autonomic dysfunction as a prognostic marker being well-established in healthy individuals and other chronic conditions, its role in patients with cancer remains underexplored. This narrative review aims to synthesize existing literature on the role of cardiac autonomic dysfunction in patients with cancer and explore the potential of physical exercise as a non-pharmacological intervention to modulate the autonomic nervous system positively.</p><p><strong>Methods: </strong>This review examines methods for assessing cardiac autonomic dysfunction, the factors contributing to its dysregulation, and the prognostic role of heart rate variability. It also analyzes current evidence on the effectiveness of various physical exercise modalities, including aerobic, resistance training, and mind-body interventions, in modulating autonomic function.</p><p><strong>Results: </strong>Patients with cancer are exposed to disease-related, lifestyle, and physiological factors that impair autonomic regulation. This dysfunction is associated with worse outcomes, such as increased mortality and disease progression. Preliminary evidence suggests that physical exercise, particularly a combination of aerobic and resistance training, as well as yoga, may improve heart rate variability and mitigate sympathovagal imbalance in patients.</p><p><strong>Conclusion: </strong>While research on the effects of physical exercise on autonomic modulation in cancer patients is still limited, early findings show promise. Further studies are needed to fully understand the mechanisms through which exercise improves cardiac autonomic function and its long-term benefits in oncology, positioning this as a novel area of research.</p>","PeriodicalId":15118,"journal":{"name":"Journal of Cancer Research and Clinical Oncology","volume":"151 6","pages":"197"},"PeriodicalIF":2.7,"publicationDate":"2025-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12204876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimal sequencing of locoregional and systemic therapies for intermediate and advanced hepatocellular carcinoma: a network meta-analysis.","authors":"Wei Lu, Zhiyuan Li, Chen Pan, Bingliang Chen, Gang Zhang, Zhiming Yang, Jingcheng Hao","doi":"10.1007/s00432-025-06233-7","DOIUrl":"10.1007/s00432-025-06233-7","url":null,"abstract":"<p><strong>Introduction: </strong>Transarterial chemoembolization (TACE), anti-angiogenic drugs (AADs), and immune checkpoint inhibitors (ICIs) are common therapies for hepatocellular carcinoma (HCC). Despite proven benefits of combined regimens, optimal sequencing remains unclear. This network meta-analysis evaluates safety and efficacy of therapeutic sequences in intermediate-advanced HCC.</p><p><strong>Methods: </strong>We conducted a comprehensive search of multiple databases, including PubMed, Cochrane Library, Web of Science, and EMBASE, for studies published until February 1, 2025. Cochrane's tools and the Newcastle-Ottawa Scale were used to assess the evaluation of bias. We performed data compilation and conducted a network meta-analysis to compare the relative efficacy of different treatments.</p><p><strong>Results: </strong>A total of 56 studies (10,456 patients) evaluated 11 therapeutic sequences. Survival outcomes favored TACE-AADs-ICIs (TAI), which ranked highest for overall survival (OS: SUCRA 90.0%) and progression-free survival (PFS: SUCRA 91.3%). Tumor responses differed significantly across regimens: TACE-ICIs (TI) achieved the highest probability of complete response rate (CRR: SUCRA 83.9%), while AADs-ICIs-TACE (AIT) ranked first in objective response rate (ORR: SUCRA 85.8%). Notably, ICIs-AADs (IA) achieved superior disease control rate (DCR: SUCRA 88.1%). ICIs monotherapy (I) was associated with the lowest incidence of grade ≥ 3 adverse events (AEs: SUCRA 11.7%).</p><p><strong>Conclusion: </strong>Our comprehensive network meta-analysis establishes a multidimensional efficacy-safety profile for sequential therapies in intermediate and advanced HCC management. TACE-initiated sequences (TAI/TIA) optimize survival (OS/PFS: SUCRA > 90%), while systemic-first regimens (AIT/IA) maximize tumor response (ORR/DCR: SUCRA > 85%). ICIs monotherapy exhibits the safest profile. Further clinical studies are warranted to determine optimal treatment sequencing for intermediate and advanced HCC.</p>","PeriodicalId":15118,"journal":{"name":"Journal of Cancer Research and Clinical Oncology","volume":"151 6","pages":"196"},"PeriodicalIF":2.7,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12198335/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}