{"title":"Innovative Biomarkers for Diagnosing Malignant Ascites in Liver Cancer.","authors":"Yan Zhang, Jing Wu, Huaizhong Cui, Xiaojing Zhang, Lingyan He, Kailong Gu, Aifang Xu","doi":"10.2147/OTT.S527224","DOIUrl":"10.2147/OTT.S527224","url":null,"abstract":"<p><strong>Background: </strong>Liver cancer ranks among the most prevalent and lethal malignancies worldwide, with metastatic malignant ascites being a common complication. This study seeks to assess the diagnostic significance of high fluorescent cells (HFCs), biochemical and tumor markers in predicting the development of metastatic malignant ascites in patients with liver cancer.</p><p><strong>Methods: </strong>We collected ascites samples from 266 patients diagnosed with liver cancer. HFC were analyzed using the BF mode of the BC-7500 hematology analyzer, assessing both relative counts (HF-BF%) and absolute counts (HF-BF#). Additionally, biochemical and tumor markers were evaluated in serum and ascites. The diagnostic accuracy of these indicators, both individually and in combination, was assessed using receiver operating characteristic (ROC) curve analysis.</p><p><strong>Results: </strong>The malignant ascites group exhibited significantly higher levels of HF-BF%, cancer ratio 2 (Ratio2, ascites LDH: ascites ADA Ratio), and neuron-specific enolase (NSE) compared to the benign group, identifying these markers as independent risk factors for malignant ascites in liver cancer patients. Ratio2 demonstrated limited diagnostic value for malignant ascites, with an area under the curve (AUC) of 0.614. In contrast, HF-BF% and NSE showed moderate diagnostic capabilities, with AUCs of 0.760 and 0.700, respectively. The combined assessment of all three indicators yielded a high diagnostic capability, with an AUC of 0.824. The critical values for NSE, HF-BF%, and Ratio2 were 11.42 U/mL, 4.35/100 WBC, and 32.82%, respectively.</p><p><strong>Conclusion: </strong>The combined evaluation of HF-BF%, Ratio2, and NSE serves as a valuable indicator for predicting the occurrence of metastatic malignant ascites in liver cancer patients.</p>","PeriodicalId":19534,"journal":{"name":"OncoTargets and therapy","volume":"18 ","pages":"865-872"},"PeriodicalIF":2.8,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12357358/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144874334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
OncoTargets and therapyPub Date : 2025-08-07eCollection Date: 2025-01-01DOI: 10.2147/OTT.S558484
{"title":"Upregulation of SHIP2 Participates in the Development of Breast Cancer via Promoting Wnt/β-Catenin Signaling [Retraction].","authors":"","doi":"10.2147/OTT.S558484","DOIUrl":"https://doi.org/10.2147/OTT.S558484","url":null,"abstract":"<p><p>[This retracts the article DOI: 10.2147/OTT.S223422.].</p>","PeriodicalId":19534,"journal":{"name":"OncoTargets and therapy","volume":"18 ","pages":"863-864"},"PeriodicalIF":2.8,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12338311/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144822166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Expression and Clinical Significance of ALDOA in Breast Cancer.","authors":"Yuning Dai, Yong Yang, Xiaohua Li, Guojian Shi, Ting Ni, Qilu Zhu, Qin He, Aoni Hu, Hao Jiang, Jianxia Liu, Ting Lu, Jie Sun, Enqiao Yu, Liang Sun","doi":"10.2147/OTT.S518473","DOIUrl":"10.2147/OTT.S518473","url":null,"abstract":"<p><strong>Background: </strong>Several malignant tumors have been shown to overexpress aldolase A (ALDOA), a crucial enzyme in the glycolytic cycle. Though, it is still unknown how ALDOA contributes to breast cancer (BC).</p><p><strong>Methods: </strong>Using GEPIA, TIMER, UALCAN, BC-GenExMiner v5.1 database, and immunohistochemistry on 96 BC patients, the expression of ALDOA was investigated. The correlation between ALDOA expression and the prognosis was evaluated by employing the Kaplan-Meier (KM) plotter in breast cancer patients.</p><p><strong>Results: </strong>The expression of ALDOA mRNA was higher in BC compared to the normal tissues. Certain subtypes of BC showed higher ALDOA expression, including micropapillary, luminal B, non-basal-like, non-triple negative breast cancer (TNBC), and luminal androgen receptor (LAR). Overexpression of ALDOA was related to the presence of lymph node metastasis (LNM), older age, high Ki67 expression, estrogen receptor (ER) and progesterone receptor (PR) positivity, and advanced Scarff-Bloom-Richardson (SBR) and Nottingham Prognostic Index (NPI) grades, while decreased ALDOA mRNA levels were observed in TNBC and basal-like BC. KM plotter showed that higher ALDOA mRNA levels predicted worse overall survival (OS), relapse-free survival (RFS), and distant metastasis-free survival (DMFS) overall. However, in BC patients with LNM, higher ALDOA levels correlated to better DMFS.</p><p><strong>Conclusion: </strong>ALDOA was a crucial prognostic factor required for BC advancement, indicating a possible target for BC treatment.</p>","PeriodicalId":19534,"journal":{"name":"OncoTargets and therapy","volume":"18 ","pages":"845-862"},"PeriodicalIF":2.8,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12333646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144817163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
OncoTargets and therapyPub Date : 2025-07-31eCollection Date: 2025-01-01DOI: 10.2147/OTT.S515194
Rita Carrilho Pichel, Lavinia Benini, Marco Romelli, Sara Gandini, Lorenzo Gervaso, Monica Valente, Maria João De Sousa, Alexandra Araújo, António Araújo, Anna Maria Di Giacomo, Nicola Fazio
{"title":"Immune-Checkpoint Inhibitors in Lung Neuroendocrine Tumors - A Systematic Review and Meta-Analysis.","authors":"Rita Carrilho Pichel, Lavinia Benini, Marco Romelli, Sara Gandini, Lorenzo Gervaso, Monica Valente, Maria João De Sousa, Alexandra Araújo, António Araújo, Anna Maria Di Giacomo, Nicola Fazio","doi":"10.2147/OTT.S515194","DOIUrl":"10.2147/OTT.S515194","url":null,"abstract":"<p><p>Lung neuroendocrine tumors (NETs) are well-differentiated neuroendocrine neoplasms of lung origin, including typical and atypical carcinoids (ACs). Therapeutic options for this rare disease are limited in daily clinical practice. Immune-checkpoint inhibitors (ICIs) are under clinical investigation. Here, we report a systematic reappraisal about ICIs results in lung NETs. We reviewed articles on observational or interventional studies that reported efficacy data of ICIs in lung NETs. Case reports and studies with insufficient data were excluded from the analysis. We searched the electronic databases Medline, Embase, Web of Science, and Cochrane Library up to May 2024. Two investigators independently screened the identified records and assessed studies quality. We summarized the results descriptively and in a meta-analysis of ORR according to the type of intervention. The search retrieved 1344 records. After selection, we included 11 studies in the meta-analysis of ORR, with a total of 128 adult patients with lung NET (25% ACs) that were progressing after at least one line of systemic therapy, including treatment with somatostatin analogs. Ten studies were Phase II, and 1 study was phase Ib. The summary ORR was 14.7% (95% CI, 5.8-32.2), 44.4% (27.2-63.1) for ACs. Subgroup analysis by intervention types showed a trend for lower ORR of lung NETs treated with ICI monotherapy (ORR: 2.7%; 0.0-63.7) compared with combinations (p-value: 0.056). The combination of temozolomide plus nivolumab showed the highest ORR (66.7%; 33.3-88.9). The median OS (reported in 2 studies) was not reached. Safety was consistent with historical data of ICIs. Our work suggests that ICIs are a promising treatment for patients with lung NETs, especially ACs, and warrant further investigation in more focused studies.</p>","PeriodicalId":19534,"journal":{"name":"OncoTargets and therapy","volume":"18 ","pages":"833-843"},"PeriodicalIF":2.8,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12325105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144794950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Advances in ORMDL Research in Malignant Tumors: A Review.","authors":"Hao Wang, Zhongquan Yi, Song Yan, Yihao Wang, Weisong Zhang, Rongqi Guo, Yangyang Li, Rui Wang, Heng Li, Xia Li, JianXiang Song","doi":"10.2147/OTT.S537194","DOIUrl":"10.2147/OTT.S537194","url":null,"abstract":"<p><p>ORMDL proteins (ORMDL1, ORMDL2, ORMDL3) are transmembrane proteins in the endoplasmic reticulum (ER) that regulate sphingolipid metabolism, maintain ER homeostasis, and modulate cellular stress responses. They influence cell proliferation, apoptosis, and metabolic balance. Recent studies have highlighted the altered expression and function of ORMDL proteins in various tumors, including breast cancer, DLBCL, colorectal cancer, and lung cancer. ORMDLs negatively regulate serine palmitoyltransferase (SPT), affecting ceramide and sphingolipid metabolism, which plays a key role in tumor cell proliferation, invasiveness, and resistance to therapy. The dysregulation of ORMDL expression may disrupt sphingolipid metabolism, trigger ER stress, and impair autophagy. Investigating ORMDL functions in cancer could lead to novel insights into tumor development and progression. ORMDL expression may serve as a potential biomarker for cancer diagnosis, prognosis, and therapeutic response prediction. Targeting ORMDL or its metabolic networks offers promising strategies for cancer therapy. Although research on ORMDLs is still in its early stages, further studies are needed to explore their roles in the tumor microenvironment, interactions with the immune system, and applications in personalized medicine. A deeper understanding of ORMDL proteins will enhance tumor diagnosis, treatment, and the development of new therapeutic approaches.</p>","PeriodicalId":19534,"journal":{"name":"OncoTargets and therapy","volume":"18 ","pages":"821-832"},"PeriodicalIF":2.8,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12316046/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144775913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
OncoTargets and therapyPub Date : 2025-07-19eCollection Date: 2025-01-01DOI: 10.2147/OTT.S526628
Jordi Martínez-Serra, Aser Alonso-Carballo, Ángel Horrillo, Paula Gómez, Oliver Vögler, Antonio Gutiérrez, Antonia Sampol
{"title":"Multiclonal Profiling of FLT3-ITD in AML Using MinION Sequencing: A Tailored Clustering Approach to Enhance Subclonal Detection.","authors":"Jordi Martínez-Serra, Aser Alonso-Carballo, Ángel Horrillo, Paula Gómez, Oliver Vögler, Antonio Gutiérrez, Antonia Sampol","doi":"10.2147/OTT.S526628","DOIUrl":"10.2147/OTT.S526628","url":null,"abstract":"<p><strong>Background: </strong>Internal tandem duplications (FLT3-ITDs) in the FLT3 gene constitute a key driver mutation in acute myeloid leukemia (AML), strongly associated with poor prognosis and therapeutic resistance. Although general-purpose structural variant callers such as Sniffles have been used to detect FLT3-ITDs, their limitations in resolving clonal diversity and low-frequency variants can lead to underrepresentation of minor clones. These shortcomings highlight the need for a dedicated bioinformatics pipeline.</p><p><strong>Materials and methods: </strong>We developed a custom clustering-based pipeline to overcome the constraints of generic SV callers, leveraging Oxford Nanopore's MinION for sequencing. Our method focuses on FLT3-ITDs by grouping near-identical insertions into biologically meaningful subclones, thereby allowing accurate variant detection of even low-frequency events. The pipeline was benchmarked against capillary electrophoresis (CE) and Sniffles at various thresholds (including 10%, 20%, and 50% allele-frequency cutoffs), with results validated via IGV inspection and cross-mapping.</p><p><strong>Results: </strong>The pipeline successfully detected FLT3-ITDs across all tested samples, including low-frequency variants and diverse subclones that Sniffles overlooked. Analyses uncovered complex multiclonal architectures composed of dominant clones (~20-25% of reads) plus multiple minor subclones differing in length, sequence, and breakpoint. Crucially, our approach identified duplications as short as 15 bp-events often dismissed by conventional SV callers. Comparative analyses showed that Sniffles failed to call several biologically validated ITDs detected by our custom pipeline.</p><p><strong>Conclusion: </strong>Third-generation sequencing combined with a tailored clustering strategy enhances the detection of FLT3-ITDs and clonal diversity in AML compared to generic variant callers. This method provides critical insights into subclonal populations driving relapse and therapeutic resistance-particularly in relapsed/refractory AML-underscoring the importance of specialized pipelines for precision medicine in leukemia.</p>","PeriodicalId":19534,"journal":{"name":"OncoTargets and therapy","volume":"18 ","pages":"811-820"},"PeriodicalIF":2.8,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12288229/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144708399","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
OncoTargets and therapyPub Date : 2025-07-18eCollection Date: 2025-01-01DOI: 10.2147/OTT.S513879
Mengli Qiu, Peiwen Guo, Jieheng Lin, Sisi Wang, Wenping Wang, Jianying Yang, Zhongming Huang, Yang Cao
{"title":"A Rare Histologic Transformation from EGFR-Positive Lung Adenocarcinoma to EGFR-Negative Squamous Cell Carcinoma After EGFR-TKIs Resistance: A Case Report.","authors":"Mengli Qiu, Peiwen Guo, Jieheng Lin, Sisi Wang, Wenping Wang, Jianying Yang, Zhongming Huang, Yang Cao","doi":"10.2147/OTT.S513879","DOIUrl":"10.2147/OTT.S513879","url":null,"abstract":"<p><p>Lung adenocarcinoma (ADC) harboring epidermal growth factor receptor (EGFR) mutations rarely transforms into squamous cell carcinoma (SCC) following resistance to targeted therapy. Here, we present a case of EGFR-positive ADC that transformed into EGFR-negative SCC after developing resistance to EGFR tyrosine kinase inhibitors (TKIs). The patient experienced progressive disease after one cycle of chemotherapy and subsequently underwent five courses of tislelizumab combined with chemotherapy. Although the primary tumor showed a partial response to this combined regimen, intracranial metastases continued to progress, ultimately leading to the patient's death. Notably, the patient survived for 8 months after SCC transformation with immuno-chemotherapy, a significantly longer duration than the previously reported median survival of 3.5 months. This case underscores the occurrence of genomic instability, histological transformation, and dissociated response (DR) following treatment with EGFR-TKIs in EGFR-positive lung ADC. We hypothesize that these phenomena may be driven by tumor heterogeneity and the dynamic variability within the tumor microenvironment (TME).</p>","PeriodicalId":19534,"journal":{"name":"OncoTargets and therapy","volume":"18 ","pages":"803-809"},"PeriodicalIF":2.7,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12283237/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144699188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
OncoTargets and therapyPub Date : 2025-07-08eCollection Date: 2025-01-01DOI: 10.2147/OTT.S518837
Huicong Liu, Hui Li, Lisha Xiao, Yubiao Guo, Gengpeng Lin
{"title":"Biomarker and Prognostic Value of Super-ARMS Detection for EGFR Mutation in Advanced NSCLC.","authors":"Huicong Liu, Hui Li, Lisha Xiao, Yubiao Guo, Gengpeng Lin","doi":"10.2147/OTT.S518837","DOIUrl":"10.2147/OTT.S518837","url":null,"abstract":"<p><strong>Background: </strong>ctDNA is a non-invasive and convenient method for detecting EGFR mutations in non-small cell lung cancer (NSCLC). However, its sensitivity is lower than that of tissue-based testing. To enhance ctDNA detection efficiency, we identified the patient population most suitable for ctDNA testing, assessed the relationship between ctDNA and tumor markers, and examined the clinical significance of ctDNA in medical practice.</p><p><strong>Methods: </strong>A single-center retrospective study was conducted, including 135 patients with NSCLC who underwent histological and liquid Super-ARMS tests. Of these, 92 patients with EGFR mutations detected in both tumor tissue and plasma were classified into the EGFR<sup>t+, p+</sup> group, while 43 patients with EGFR mutations detected only in tumor tissue were classified into the EGFR<sup>t+, p-</sup> group. The clinical features and outcomes between these two groups were compared.</p><p><strong>Results: </strong>The positivity rate of Super-ARMS test was 68.1% (92/135). The presence of EGFR<sup>t+, p+</sup> in the Super-ARMS test was significantly associated with pleural effusion, bone, liver, and multiple organ metastases. Compared to the EGFR<sup>t+, p+</sup> group, the EGFR<sup>t+, p-</sup> group had a significantly better PFS (<i>P</i> < 0.01). Carcinoembryonic antigen (CEA) levels demonstrated a strong predictive value for identifying plasma EGFR-mutated patients (AUC 0.828, sensitivity 68.8%, specificity 84.4%), while Maximum Standardized Uptake Value (SUV<sub>max</sub>) also showed diagnostic value for plasma EGFR-mutated patients (AUC 0.78). Additionally, combination of TP53 and EGFR mutations in plasma provided improved risk stratification for PFS (<i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>Patients exhibiting metastasis, elevated levels of tumor markers and SUV<sub>max</sub> are more suitable for plasma EGFR mutation testing in clinical NSCLC management. Moreover, a positive plasma ctDNA test not only guides targeted therapy but also predicts a worse prognosis.</p>","PeriodicalId":19534,"journal":{"name":"OncoTargets and therapy","volume":"18 ","pages":"789-801"},"PeriodicalIF":2.7,"publicationDate":"2025-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12255349/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
OncoTargets and therapyPub Date : 2025-07-07eCollection Date: 2025-01-01DOI: 10.2147/OTT.S516341
Chaoying Chen, Lin Chen, Weifeng Zheng, Yiyang Dai
{"title":"The Potential Role and Effective Components of Sanyeqing as the Potential Therapeutic Candidates for IBD and CRC.","authors":"Chaoying Chen, Lin Chen, Weifeng Zheng, Yiyang Dai","doi":"10.2147/OTT.S516341","DOIUrl":"10.2147/OTT.S516341","url":null,"abstract":"<p><p>Inflammatory bowel disease (IBD) is a family of chronic inflammatory diseases such as Crohn's disease (CD) and ulcerative colitis (UC). Among the serious malignancies that can arise from IBD, colorectal cancer is particularly prevalent. Individuals suffering from both IBD and CRC often endure similar symptoms, which include diarrhea, rectal bleeding, abdominal discomfort, weight decline, and profound exhaustion. Sanyeqing is a traditional herbaceous medicinal plant with anti-tumor, anti-inflammatory, analgesic, heat-clearing, detoxifying, and liver-protecting effects. Here, we summarize the possible molecular mechanisms of IBD and CRC, and summarize the potential role of Sanyeqing in clinical therapy for IBD and CRC. Investigating the etiology of enteritis and intestinal cancer, as well as exploring Sanyeqing's potential as a preventive and therapeutic agent, is of paramount importance in the battle against these diseases.</p>","PeriodicalId":19534,"journal":{"name":"OncoTargets and therapy","volume":"18 ","pages":"779-788"},"PeriodicalIF":2.7,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12248236/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Survival Outcomes in Lung Cancer Patients Newly Diagnosed Through Brain Metastasis Surgery: Impact of Druggable Mutations and Radiotherapy.","authors":"Tzu-I Chuang, Kuo-Hsuan Hsu, Po-Hsin Lee, Jeng-Sen Tseng, Yu-Wei Hsu, Chih-Hsiang Liao, Yen-Hsiang Huang, Tsung-Ying Yang","doi":"10.2147/OTT.S520700","DOIUrl":"10.2147/OTT.S520700","url":null,"abstract":"<p><strong>Background: </strong>Precocious brain metastasis in lung cancer, diagnosed through surgical resection before primary lung cancer detection, represents a unique clinical scenario with limited research. This study aims to investigate the clinical characteristics, prognosis, and the impact of different treatments on survival outcomes in this distinct population.</p><p><strong>Materials and methods: </strong>We retrospectively analyzed clinical outcomes of lung cancer patients newly diagnosed following brain metastasis decompression surgery in our institute, over a period from July 2012 to May 2023. Patient demographics including gender, age, surgical approach, pathological findings, receipt of radiotherapy, systemic treatment modalities, and presence of druggable mutations were documented. Druggable mutations were defined as actionable genetic alterations (AGAs) detected in patients for which corresponding targeted therapeutic agents were available.</p><p><strong>Results: </strong>Among 64 patients analyzed, 53 (82.8%) were diagnosed with adenocarcinoma; 38 (59.4%) harbored druggable mutations. There was only one patient with small cell carcinoma in this series. Types of druggable mutations were discussed in the study. The clinical stage was IVB among 38 (59.4%) patients. Forty-nine (76.6%) patients had metastatic brain lesions with number ≦3. Thirty-five (54.7%) patients received post-operative radiotherapy. The cohort's median overall survival (OS) was 19.6 months. Patients with druggable mutations had an OS longer than patients without druggable mutation (46.0 vs 14.5 months, Log rank test <i>p =</i>0.004). Among patients with druggable mutations, we found no difference in characteristics between patients with and without post-operative cranial radiotherapy. Patients receiving post-operative cranial radiotherapy did not show significantly better clinical efficacy than patients without radiotherapy (adjusted hazard ratio: 0.68, 95% confidence interval 0.16 to 2.91).</p><p><strong>Conclusion: </strong>In patients with precocious brain metastases from lung cancer, the presence of druggable mutations and subsequent targeted therapy significantly extended survival, whereas post-operative brain radiotherapy may not confer additional survival benefits. These findings highlight the importance of molecular profiling and targeted therapy in this unique patient population.</p>","PeriodicalId":19534,"journal":{"name":"OncoTargets and therapy","volume":"18 ","pages":"751-761"},"PeriodicalIF":2.7,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12206598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144529051","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}