Oncology Research and Treatment最新文献

{"title":"Thoracic Oncology Highlights from the European Society for Medical Oncology Annual Meeting 2024: Targeted Therapies in Non-Small Cell Lung Cancer.","authors":"Maximilian Webendörfer, Sophie Heinzen, Christine Sibbert, Marie-Elisabeth Leßmann, Cornelia Kropf-Sanchen, Michael Thomas, Amanda Tufman, Annalen Bleckmann, Marcel Wiesweg, Frank Griesinger, Lea Reitnauer, Tobias Raphael Overbeck","doi":"10.1159/000542957","DOIUrl":"10.1159/000542957","url":null,"abstract":"","PeriodicalId":19543,"journal":{"name":"Oncology Research and Treatment","volume":" ","pages":"142-147"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142770947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Epidural Anesthesia on the Outcome of Elderly Patients with Endometrial Cancer: Results of a Propensity Score-Matched Analysis.","authors":"Valerie Catherine Linz, Marco Johannes Battista, Regina Hummel, Markus Schepers, Eva-Verena Griemert, Mona Wanda Schmidt, Marcus Schmidt, Annette Hasenburg, Katharina Gillen","doi":"10.1159/000543540","DOIUrl":"10.1159/000543540","url":null,"abstract":"<p><strong>Introduction: </strong>Epidural anesthesia is a standard procedure to mitigate pain during surgery for endometrial cancer (EC). Little data exist about the influence of epidural anesthesia on the oncological outcome in elderly patients with EC. This retrospective study aimed to investigate potential correlations between epidural anesthesia and cancer recurrence in patients with EC.</p><p><strong>Methods: </strong>We screened the medical records of patients ≥60 years treated surgically for EC at the University Medical Center Mainz between January 2008 and December 2019. All women underwent general anesthesia (GA) alone or combined with epidural anesthesia (EGA). Cox regression, the Kaplan-Meier method and propensity score matching were used to analyze the prognostic influence of the anesthesiologic regime on survival.</p><p><strong>Results: </strong>A total of 152 women with EC were included. Twenty-nine patients (19.1%) formed the EGA cohort. The median time of follow-up (FU) was 31 months (interquartile range [IQR]: 8-67.5). The EGA cohort showed more in-hospital complications (27.6 vs. 8.9%; p = 0.006), especially thromboembolic events (3 vs. 0 events; p = 0.006), as well as a longer hospital stay (11 [IQR: 8-13] vs. 7 [IQR: 4-9] days; p < 0.001). Twenty-six patients (17.1%) developed a recurrence in the follow-up at a median of 13 months [IQR: 7.75-29.5]. Thirty-two patients died during FU (21.1%). The EGA cohort showed higher FIGO stages and a higher histological grading than the GA cohort. In the Kaplan-Meier analysis, EGA showed a significantly reduced 5-year recurrence-free survival (RFS) (36.5% vs. 72.6%, p < 0.001) and overall survival (OS) (58.6% vs. 79.9%, p = 0.008). However, in multivariate Cox regression analysis including FIGO stages and histological grading, EGA did not influence RFS (HR: 2.02; 95%-CI: [0.99-4.12], p = 0.054), and OS (HR: 1.03; 95%-CI: [0.40-2.66], p = 0.951). This was backed up by the propensity score- matched analysis for survival (RFS: p = 0.604, OS: p = 0.86).</p><p><strong>Conclusion: </strong>Considering risk factors, epidural anesthesia in combination with GA did not differ in recurrence-free and overall survival compared to GA. Prospective randomized trials are warranted in order to further evaluate this topic.</p>","PeriodicalId":19543,"journal":{"name":"Oncology Research and Treatment","volume":" ","pages":"341-350"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140583/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143502140","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":"[Supportive Therapie bei Krebs: AGSMO Jahreskongress 2025, 24. Mai 2025, Berlin und online - Abstracts].","authors":"","doi":"10.1159/000545615","DOIUrl":"https://doi.org/10.1159/000545615","url":null,"abstract":"","PeriodicalId":19543,"journal":{"name":"Oncology Research and Treatment","volume":"48 Suppl 1","pages":"1-14"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving Accuracy and Source Transparency in Responses to Soft Tissue Sarcoma Queries Using GPT-4o Enhanced with German Evidence-Based Guidelines.","authors":"Cheng-Peng Li, Wei-Wei Jia, Yuan Chu, Franka Menge, Tobias Speer, Christoph Reißfelder, Peter Hohenberger, Jens Jakob, Cui Yang","doi":"10.1159/000544978","DOIUrl":"10.1159/000544978","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to evaluate the effectiveness of GPT-4o, with and without retrieval-augmented generation (RAG), in responding to soft tissue sarcoma (STS)-related queries.</p><p><strong>Methods: </strong>The study used a 20-question dataset derived from clinical scenarios related to adult STS. The responses were generated by GPT-4o with and without the RAG approach. The RAG system incorporated the English version of German evidence-based S3 guidelines through an embedding-based retrieval system. Two sarcoma experts evaluated the responses for accuracy, comprehensiveness, and safety using a Likert scale. Statistical analyses were conducted to compare the performances.</p><p><strong>Results: </strong>GPT-4o with RAG outperformed the model without RAG across all evaluated areas (p < 0.05). GPT-4o without RAG had a 40% error rate, which was reduced to 10% by the RAG approach. In 90% of the questions, the pages with the relevant information that addressed the questions were correctly cited using the retrieval system.</p><p><strong>Conclusion: </strong>The RAG approach significantly enhanced the performance of GPT-4o in answering STS-related questions. However, the model still produced incorrect responses in certain complex scenarios. GPT-4o, even with RAG, should be used cautiously in clinical settings, particularly for rare diseases like sarcoma. Human expertise remains irreplaceable in medical decision-making.</p>","PeriodicalId":19543,"journal":{"name":"Oncology Research and Treatment","volume":" ","pages":"351-359"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modifications to Prostate Cancer Diagnosis following COVID-19 and Following Models.","authors":"Miroslav Stojadinovic, Milorad Stojadinovic, Slobodan Jankovic","doi":"10.1159/000544977","DOIUrl":"10.1159/000544977","url":null,"abstract":"<p><strong>Introduction: </strong>The COVID-19 pandemic has impacted the treatment of prostate cancer (PCa). The study examines any predictions that could point to future models.</p><p><strong>Methods: </strong>Two interrupted time series analyses were conducted: one for the pre-COVID period (January 2017 to December 2019) and another for the post-COVID period during 2022. Information on age, total prostate-specific antigen (PSA), abnormal digital rectal exam (DRE), prostate volume, previous negative biopsy, number of positive biopsies, Gleason score, and biopsy outcome were collected for all patients. The categories for the results were no cancer, insignificant, low and intermediate, high-risk, and very high-risk PCa. Using a generalized linear model (GLM), the outcomes are modeled. The area under the curve (AUC) and accuracy were used to assess how well multi-class predictions performed.</p><p><strong>Results: </strong>Overall, 244 patients who had biopsies following the COVID-19 pandemic and 832 patients who had biopsies before the pandemic were compared. The accuracy of the GLM was only 0.635. The AUC for categories no-cancer, low- and intermediate-risk, and very high-risk patients was 0.821, 0.716, and 0.926. With scaled relevance values, PSA was the most critical test. The two features that significantly influenced the treatment model prediction for PCa were biopsy PSA level and DRE, respectively.</p><p><strong>Conclusion: </strong>Advanced age and a very high-risk group appear to have a detrimental impact on the results of biopsies conducted after the first wave of the COVID-19 era. At the same time, PSA levels and abnormal DRE are the most significant predictors in GLM.</p>","PeriodicalId":19543,"journal":{"name":"Oncology Research and Treatment","volume":" ","pages":"332-340"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex-Disaggregated Analysis of Central Venous Catheter-Related Bloodstream Infections in Patients with Cancer.","authors":"Enrico Schalk, Alva Seltmann, Boris Böll, Nicola Giesen, Judit Grans-Siebel, Oliver Kriege, Julia Lanznaster, Antrea Minti, Jan-Hendrik Naendrup, Julia Neitz, Jens Panse, Martin Schmidt-Hieber, Ruth Seggewiss-Bernhardt, Daniel Teschner, Philipp Weber, Kai Wille, Marie von Lilienfeld-Toal, Marcus Hentrich","doi":"10.1159/000542535","DOIUrl":"10.1159/000542535","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Men are generally more susceptible to bacterial infections than women. Central venous catheters (CVCs), often used to administer systemic treatment in patients with cancer, are an important source of infection. However, little is known about sex-specific differences of CVC-related bloodstream infections (CRBSIs) in patients with cancer. This study aimed to compare CRBSIs in men versus women in a large cohort of patients with cancer.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Data were derived from the SECRECY registry including nonselected patients with centrally inserted non-tunneled internal jugular or subclavian vein CVCs in 10 hematology and oncology sites in Germany. Only CRBSIs classified as definite CRBSI (dCRBSI) or probable CRBSI were included, and the combination of both was summarized as dpCRBSI. CVCs were matched 1:1 for underlying disease, anatomic site of CVC insertion, type of CVC dressing, antimicrobial coated CVC, complicated CVC insertion, and CVC in situ time by propensity score matching (PSM). Endpoints were CRBSI rates and incidences in CVCs inserted in men versus women.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 5,075 CVCs registered from March 2013 to March 2024 were included in the analysis, of which 3,024 comprise the PSM cohort. A total of 1,512 (50.0%) CVCs were inserted in men. Underlying diseases mainly were hematological malignancies (96.4%). While there was no statistically significant difference between men and women in the dCRBSI rate (5.4% vs. 4.1%; p = 0.12) and the dCRBSI incidence (3.8 vs. 2.9/1,000 CVC days; p = 0.11), the rate of dpCRBSI (9.9% vs. 6.7%; p = 0.002) and the dpCRBSI incidence (7.0 vs. 4.7/1,000 CVC days; p = 0.002) were significantly higher in men versus women. The proportion of coagulase-negative staphylococci as causative agent of both dCRBSI and dpCRBSI was higher in men than in women (58.8% vs. 41.2%; p = 0.07 and 61.5% vs. 38.5%; p = 0.002, respectively). A multivariable regression revealed neutropenia as an independent risk factor for dCRBSI and male sex as risk factor for dCRBSI and dpCRBSI.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;In patients with hematological malignancies, men have a higher risk of CRBSI than women. This finding may be attributed to the high number of jugular vein-inserted CVCs, which in men may be associated with higher rates of skin colonization than in women. Special preventive measures such as earlier removal of CVCs in men may be studied in future.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Men are generally more susceptible to bacterial infections than women. Central venous catheters (CVCs), often used to administer systemic treatment in patients with cancer, are an important source of infection. However, little is known about sex-specific differences of CVC-related bloodstream infections (CRBSIs) in patients with cancer. This study aimed to compare CRBSIs in men versus women in a large cohort of patients with cancer.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;D","PeriodicalId":19543,"journal":{"name":"Oncology Research and Treatment","volume":" ","pages":"37-47"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11809521/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142625178","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":"New Insights from Long-Term Clinical Use of Circulating Tumor DNA-Based Minimal Residual Disease Monitoring in Translocation-Associated Sarcomas.","authors":"Sophie Joch, Maria Anna Smolle, Karl Kashofer, Andrea Thüringer, Joanna Szkandera, Martin Benesch, Amin El-Heliebi, Bernadette Liegl-Atzwanger, Andreas Leithner, Markus G Seidel","doi":"10.1159/000543223","DOIUrl":"10.1159/000543223","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Assessment of circulating tumor DNA (ctDNA) as a means to monitor disease activity in translocation-associated tumors has become very popular in clinical practice. However, there are still few studies on its clinical application to date. Our study evaluates the clinical applicability of ctDNA as a biomarker for monitoring minimal residual disease (MRD) in patients with translocation-associated sarcomas.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In this retrospective study, we correlated 285 ctDNA samples from 34 patients diagnosed with translocation-associated sarcoma with the clinical course and images. Blood samples were collected at multiple time points during follow-up (median: 97 weeks, range: 7-398).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;We discovered a significant association between ctDNA levels and the clinical course of the disease, particularly noting differences between patients in remission or with progressive disease (p = 0.001). Furthermore, although we noted that ctDNA levels remained undetectable in a few cases of unilocular recurrence (n = 3), they were consistently higher in patients with multilocular recurrence (n = 14; p = 0.008).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Monitoring ctDNA levels provides highly specific, additional information enabling early recurrence detection in patients with translocation-associated sarcomas during the follow-up and can be integrated into clinical practice. However, MRD monitoring by ctDNA quantification alone does not allow the reliable detection of 100% of unilocular recurrences and should be complemented by the use of conventional imaging techniques.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Assessment of circulating tumor DNA (ctDNA) as a means to monitor disease activity in translocation-associated tumors has become very popular in clinical practice. However, there are still few studies on its clinical application to date. Our study evaluates the clinical applicability of ctDNA as a biomarker for monitoring minimal residual disease (MRD) in patients with translocation-associated sarcomas.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In this retrospective study, we correlated 285 ctDNA samples from 34 patients diagnosed with translocation-associated sarcoma with the clinical course and images. Blood samples were collected at multiple time points during follow-up (median: 97 weeks, range: 7-398).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;We discovered a significant association between ctDNA levels and the clinical course of the disease, particularly noting differences between patients in remission or with progressive disease (p = 0.001). Furthermore, although we noted that ctDNA levels remained undetectable in a few cases of unilocular recurrence (n = 3), they were consistently higher in patients with multilocular recurrence (n = 14; p = 0.008).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Monitoring ctDNA levels provides highly specific, additional information enabling early recurrence detection in patients wit","PeriodicalId":19543,"journal":{"name":"Oncology Research and Treatment","volume":" ","pages":"186-196"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11974511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142882333","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":"Multi-Targeting CAR-T Cell Strategies to Overcome Immune Evasion in Lymphoid and Myeloid Malignancies.","authors":"Jessica Peter, Fabio Toppeta, Alexandre Trubert, Sophia Danhof, Michael Hudecek, Thomas Däullary","doi":"10.1159/000543806","DOIUrl":"10.1159/000543806","url":null,"abstract":"<p><strong>Background: </strong>Chimeric antigen receptor (CAR)-T cell therapy has become a groundbreaking treatment for hematological malignancies, particularly lymphomas and multiple myeloma, with high remission rates in refractory and relapsed patients. However, most CAR-T therapies target a single antigen, such as CD19, which can result in immune evasion through antigen escape. This mechanism describes the downregulation or complete loss of the targeted antigen by the tumor cells, eventually leading to relapse. To address this issue, multi-targeting strategies like logic-gated CARs, adapter CARs, or combination therapies can increase the potency of CAR-T cells. These approaches aim to minimize immune evasion by targeting multiple antigens simultaneously, thereby increasing treatment durability. Additionally, advanced tools such as next-generation sequencing (NGS), direct stochastic optical reconstruction microscopy (dSTORM), or multiparametric flow cytometry are helping to identify novel tumor-specific targets and improve therapy designs.</p><p><strong>Summary: </strong>This review explores the current landscape of CAR-T cell therapies in lymphoid and myeloid malignancies, highlights ongoing clinical trials, and discusses the future of these innovative multi-targeting approaches to improve patient outcome.</p><p><strong>Key messages: </strong>Antigen escape limits CAR-T cell therapy success, but multi-targeting strategies like logic gates and adapter CARs offer solutions. Optimizing antigen selection and CAR design, along with larger clinical trials, is essential for improving patient outcomes. Personalization using advanced technologies like CRISPR screening and single-cell RNA sequencing can enhance durability and effectiveness of treatments for heavily pretreated patients.</p>","PeriodicalId":19543,"journal":{"name":"Oncology Research and Treatment","volume":" ","pages":"265-279"},"PeriodicalIF":2.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment Satisfaction and Treatment Wishes of Patients with Chronic Cancer-Related Pain.","authors":"Hannes Hofbauer, Birgit Abberger, Nadia Kheirandish, Kristin Kieselbach, Kristin Kieselbach","doi":"10.1159/000545363","DOIUrl":"10.1159/000545363","url":null,"abstract":"<p><strong>Introduction: </strong>Up to 40% of long-term cancer survivors suffer from chronic cancer-related pain (CCRP) with often inadequate treatment. CCRP is influenced by biopsychosocial factors, with interdisciplinary multimodal pain therapy (IMPT) being a comprehensive treatment option. In our study, patients with CCRP were asked about their treatment satisfaction and treatment wishes.</p><p><strong>Methods: </strong>Two anonymous online surveys on CCRP in long-term survivors were analyzed: survey 1 from cancer self-help group members and survey 2 from patients with CCRP assessed at the Interdisciplinary Pain Center (IPC), resulting in recommendations ranging from outpatient treatment to IMPT.</p><p><strong>Results: </strong>Thirty-eight members of 8 self-help groups in survey 1 and 50 of 158 patients with CCRP in survey 2 completed the questionnaire. In both surveys, relevant pain impairment and pain therapy dissatisfaction were identified. A higher intensity of therapy, including the implementation of IMPT, did not lead to better pain control. Consistent with the biopsychosocial factors in CCRP, increased depression scores and increased treatment dissatisfaction correlated. In both surveys, participants expressed extensive therapy wishes.</p><p><strong>Conclusion: </strong>Despite comprehensive therapeutic approaches, long-term survivors with CCRP suffer from severe pain and treatment dissatisfaction. Biopsychosocial influences are evident, with depression worsening treatment satisfaction. Classical IMPT for CCRP may not be targeted enough and a more specific therapeutic approach should be developed and must be tested using patient-reported outcome measures.</p>","PeriodicalId":19543,"journal":{"name":"Oncology Research and Treatment","volume":" ","pages":"437-447"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and Efficacy of Pharmacotherapy Containing the Second-Generation Integrase Inhibitors and Chemotherapy Drugs in AIDS-Related Diffuse Large B-Cell Lymphoma: A Single-Center Retrospective Analysis.","authors":"Jing Yang, Xingzhen Cheng, Guo Wei, Tingyu Chen, Yong Zhao, Yong Zhao","doi":"10.1159/000545644","DOIUrl":"10.1159/000545644","url":null,"abstract":"<p><strong>Introduction: </strong>Previous research indicates that combining antiviral and anti-tumor drugs may lead to compounded toxic side effects and risks of drug-drug interactions. Our study aimed to investigate the safety and effectiveness of pharmacotherapy combining second-generation integrase inhibitors (INSTIs) with chemotherapy drugs in patients with AIDS-related diffuse large B-cell lymphoma (AR-DLBCL).</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of newly diagnosed AR-DLBCL patients at the Public Health Clinical Center of Chengdu from February 2020 to May 2023. All patients received a second-generation INSTI-based regimen alongside chemotherapy. Primary endpoints included the frequency and severity of adverse effects (AEs), while secondary endpoints encompassed CD4 count, CD4/CD8 ratio, HIV viral load, and complete response (CR), partial response (PR), and overall response rate (ORR) at the end of treatment. Evaluations were performed at each chemotherapy cycle, with AEs assessed using Common Terminology Criteria for Adverse Events, version 4.02.</p><p><strong>Results: </strong>We enrolled 96 AR-DLBCL patients with a median follow-up of 15.5 months (range: 5-33). Of these patients, 60 received bictegravir/tenofovir alafenamide/emtricitabine, while 36 were treated with dolutegravir/lamivudine/albuvirtide as their antiretroviral therapy regimen. Regarding chemotherapy, 75 patients underwent R±CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone), while 21 received R±EPOCH (rituximab, etoposide, doxorubicin, vincristine, cyclophosphamide, and prednisone). The most common grade 3 or higher AEs during treatment were neutropenia (32.29%) and thrombocytopenia (20.83%). Seven patients experienced serious complications during treatment, including pulmonary tuberculosis (2), multiple organ dysfunction (1), intracranial infection (1), renal failure (1), and severe COVID-19 (2), resulting in 3 deaths. CD4 count and CD4/CD8 ratio showed slight decreases from baseline (251.76 ± 188.53 cells/μL and 0.71 ± 0.69, respectively) to the 6th month (233.44 ± 140.53 cells/μL and 0.66 ± 0.55, respectively), with no statistical significance observed (p = 0.375 and p = 0.608). Viral load rebound was not observed. The objective response rate was 85.41%, with a CR rate of 51.04%. As of June 2024, 15 patients had died from severe infections or progressive disease.</p><p><strong>Conclusion: </strong>Second-generation INSTIs seem to be a safe and effective first-line treatment option for AR-DLBCL patients undergoing chemotherapy, regardless of the chemotherapy type.</p>","PeriodicalId":19543,"journal":{"name":"Oncology Research and Treatment","volume":" ","pages":"426-436"},"PeriodicalIF":1.6,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12068825/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780801","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}