Therapeutic Advances in Medical Oncology最新文献

{"title":"Development and validation of prognostic prediction models for early-stage cervical cancer patients based on pathological intermediate-risk factors.","authors":"Zihan Wang, Ran Chu, Namei Wu, Ming Yuan, Xiao Song, Wei Tian, Chunrun Yang, Jipeng Wan, Guoyun Wang","doi":"10.1177/17588359251359461","DOIUrl":"10.1177/17588359251359461","url":null,"abstract":"<p><strong>Background: </strong>The combination patterns of pathological intermediate-risk factors and the choice of adjuvant therapy for early-stage cervical cancer (CC) remain controversial.</p><p><strong>Objectives: </strong>To develop and validate nomogram-based prediction models incorporating pathological intermediate-risk factors to predict survival outcomes and optimize adjuvant therapy strategies in early-stage CC patients.</p><p><strong>Design: </strong>A multicenter retrospective study.</p><p><strong>Methods: </strong>A total of 1104 patients with stage IB-IIA CC who underwent primary surgical treatment and had no pathological high-risk factors were retrospectively enrolled from three tertiary medical centers in China between January 2005 and December 2017. Patients were randomly assigned to development and validation cohorts (approximately 3:1 ratio). Prognostic models for disease-free survival (DFS) and overall survival (OS) were developed by Cox proportional hazards regression and visualized using nomograms.</p><p><strong>Results: </strong>In this study, four prognostic models were developed incorporating different combinations of five key variables: lymphovascular space involvement (LVSI), stromal invasion (SI), tumor size (TS), histological type, and adjuvant therapy. Among these, Model 4 (LVSI + SI + TS + histological type + adjuvant therapy) demonstrated the highest discriminatory performance, with C-indices of 0.79 for both DFS and OS in the development cohort, and 0.84 for DFS and 0.77 for OS in the validation cohort. Model 4 also effectively stratified patients into prognostic risk groups in both cohorts, with high-risk patients exhibiting significantly worse DFS (development cohort: <i>p</i> < 0.0001; validation cohort: <i>p</i> = 0.0011) and OS (development cohort: <i>p</i> < 0.0001; validation cohort: <i>p</i> = 0.0036) compared to low-risk patients.</p><p><strong>Conclusion: </strong>The nomogram models developed in this study may provide individualized prognostic predictions for early-stage CC patients, potentially facilitating personalized decision-making regarding adjuvant therapy, though further validation in diverse patient cohorts and prospective studies is needed.</p>","PeriodicalId":23053,"journal":{"name":"Therapeutic Advances in Medical Oncology","volume":"17 ","pages":"17588359251359461"},"PeriodicalIF":4.2,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12301605/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Establishment and validation of a convenient and efficient screening tool for active pulmonary tuberculosis in lung cancer patients based on common parameters.","authors":"Fan Zhang, Fei Qi, Mengyan Sun, Peng Jiang, Minghang Zhang, Xiaomi Li, Yujie Dong, Juan Du, Liang Li, Tongmei Zhang","doi":"10.1177/17588359251355058","DOIUrl":"10.1177/17588359251355058","url":null,"abstract":"<p><strong>Background: </strong>Coexistent pulmonary tuberculosis and lung cancer (PTB-LC) is a rare type of disease with frequent under- and/or mis-diagnosis. Establishment of a reliable screening model for PTB-LC holds considerable medical and economic significance.</p><p><strong>Objectives: </strong>We aimed to develop an efficient and convenient tool to identify high-risk individuals for tuberculosis (TB) infection among LC patients based on commonly available parameters in clinical practice.</p><p><strong>Design: </strong>This study consisted of a primary retrospective patient cohort for model construction and verification, and a prospective patient cohort for prospective validation.</p><p><strong>Methods: </strong>Patients with active PTB-LC and LC diagnosed in Beijing Chest Hospital from 2018 to 2022 were collected and 1:1 matched according to time of admission and were classified into a training set (<i>n</i> = 281) and testing set (<i>n</i> = 121). Baseline information, clinicopathological features, imaging manifestations, and blood testing results were collected and analyzed. Five machine learning methods, including logistic regression (LR), random forest (RF), support vector machine (SVM), decision tree (DT), and neural network (NN), were employed to develop a screening model for PTB-LC.</p><p><strong>Results: </strong>Through multivariable analysis, gender, pleural effusion, cavitation, monocyte count (MONO), and plasma adenosine deaminase (ADA) levels were identified as independent predictors of PTB-LC and included in model construction. LR, RF, SVM, DT, and NN were used to construct the screening or pre-diagnosis models. The RF demonstrated the best performance with an area under the curve of 0.966 in the training set, 0.817 in the testing set, and 0.805 in the prospective dataset. The accuracy, precision, recall, and F1 score of the RF model of the training set were 0.88, 0.87, 0.89, and 0.88, respectively, and these indicators of the testing set were 0.71, 0.75, 0.72, and 0.74, respectively, which were superior to those of other methods. The prospective cohort further validated the good performance of the screening model. We also established a nomogram with gender, pleural effusion, cavitation, MONO, and serum ADA in assessing high-risk patients of developing TB infection. Further TB-related diagnostic tests were recommended for these high-risk patients.</p><p><strong>Conclusion: </strong>The RF screening model constructed with gender, pleural effusion, cavitation, MONO, and ADA may help identify high-risk patients of PTB-LC from LC alone cases.</p>","PeriodicalId":23053,"journal":{"name":"Therapeutic Advances in Medical Oncology","volume":"17 ","pages":"17588359251355058"},"PeriodicalIF":4.2,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12301598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of immune checkpoint inhibitor combinations in resectable and unresectable, embolization-eligible hepatocellular carcinoma.","authors":"Brandon M Meyers, Howard J Lim, Mayur Brahmania, Dave M Liu, Vincent C Tam, Deanna McLeod, Ravi Ramjeesingh, Jennifer J Knox, Arndt Vogel","doi":"10.1177/17588359251357719","DOIUrl":"10.1177/17588359251357719","url":null,"abstract":"<p><p>Immune checkpoint inhibitor (ICI) combination regimens have recently become the new standard of care for advanced hepatocellular carcinoma (HCC). Large, phase III registrational trials of ICI-containing regimens in resectable and embolization-eligible settings are now reading out. This review summarizes and critically appraises efficacy and safety data from these studies with consideration of the optimal use of ICIs in conjunction with antiangiogenic agents including important issues in management of HCC across the continuum of care such as those related to patient selection, treatment sequencing, and liver preservation. IMbrave050 assessed atezolizumab plus bevacizumab in resected HCC and EMERALD-1 and LEAP-012 evaluated addition of durvalumab-bevacizumab and pembrolizumab-lenvatinib to transarterial chemoembolization in unresectable, embolization-eligible HCC. Both EMERALD-1 and LEAP-012 met the primary endpoint of progression-free survival. While IMbrave050 initially met its primary endpoint of recurrence-free survival, the adjuvant atezolizumab-bevacizumab benefit was not maintained in an updated analysis. Survival benefits remain unclear for all phase III trials. Safety outcomes can be generally described as predictable based on experience with the respective experimental regimens in the advanced setting. Treatment selection in embolization-eligible settings should consider risks and benefits with special consideration of liver preservation. Additional research is required to optimize ICI combination use in the perioperative and peri-embolization settings.</p>","PeriodicalId":23053,"journal":{"name":"Therapeutic Advances in Medical Oncology","volume":"17 ","pages":"17588359251357719"},"PeriodicalIF":4.2,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12301614/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733424","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advances in immuno-based and targeted therapies in extensive-stage small cell lung cancer.","authors":"Xiao-Tong Zou, Jie Huang, Hao Sun, Li-Na Chen, Xiu-Hao Zhang, Jin-Ji Yang","doi":"10.1177/17588359251359057","DOIUrl":"10.1177/17588359251359057","url":null,"abstract":"<p><p>Immunotherapy now plays a key role in supplementing and even replacing conventional agents in tumor treatment. Immune checkpoint inhibitors (ICIs), represented by atezolizumab and durvalumab, have shown encouraging therapeutic effects in the combination chemotherapy for extensive-stage small cell lung cancer (SCLC) and have become preferred regimens. It has marked a seminal shift in the treatment landscape with achieving for the first time that overall survival exceed 1 year. However, the extent to which SCLC patients can benefit from ICIs is limited, and ICIs' combination treatment strategies still need to be continuously explored. Beyond the ICIs in combination with radiotherapy, the anti-angiogenic target has been a combination option to improve effectiveness. And the novel formula of immune drugs, such as antibody-drug conjugates, bispecific T cell engager therapy, and chimeric antigen receptor T-cell immunotherapy, also promotes the potential option for SCLC patients. Based on the molecular development and biomarkers analysis of the sensitivity to immune checkpoint of the SCLC subtypes, the exploration of new targets and the development of drugs with novel mechanisms may provide fresh hope for immunotherapy in SCLC.</p>","PeriodicalId":23053,"journal":{"name":"Therapeutic Advances in Medical Oncology","volume":"17 ","pages":"17588359251359057"},"PeriodicalIF":4.2,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12301644/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733358","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pancreatic neuroendocrine tumors and <i>MUTYH</i> pathogenic variants: a multinational study.","authors":"Rachel P Riechelmann, Giovana T Torrezan, Emily Bergsland, Nitya Raj, Jonathan Strosberg, Farhana Moon, Tiago C Felismino, Stian Knappskog, Elena Trevizani, Sara Cingarlini, Halfdan Sorbye","doi":"10.1177/17588359251356335","DOIUrl":"10.1177/17588359251356335","url":null,"abstract":"<p><strong>Background: </strong>Germline pathogenic variants (GPV) in <i>MUTYH</i> are rare in patients with pancreatic neuroendocrine tumors (PanNET).</p><p><strong>Objectives: </strong>We aimed to characterize PanNET patients with GPV and/or somatic pathogenic variants (SPV) in <i>MUTYH</i>.</p><p><strong>Design: </strong>Retrospective multicenter cohort.</p><p><strong>Methods: </strong>Patients with PanNET harboring <i>MUTYH</i> pathogenic variants (<i>MUTYH</i>+) were identified from centers in Brazil, Europe, and the USA. Data were extracted from medical records. Germline or somatic variants were evaluated by targeted sequencing of cancer-associated genes. The primary endpoint was to clinically characterize these patients and the secondary endpoint was overall survival (OS). Aggressive behavior was defined as rapid progression, transformation to neuroendocrine carcinoma (NEC)-like histology and/or OS of <2 years from first-line treatment. All cases were diagnosed by expert pathologists.</p><p><strong>Results: </strong>In total, 23 patients with <i>MUTYH</i>+-associated PanNET were identified (17 germline; 4 somatic). Median age was 48 years (22-72), 65% were male, 12 (52%) had first-degree family history of cancer, and 70% had synchronic metastatic disease. Tumors were of G1, G2, and G3 in 17%, 52%, and 31%, of cases, respectively, and median KI-67 was 12% (2%-80%). Seven of 11 (64%) G1/G2 PanNET with tumor biopsy upon progression evolved to G3 (3 NEC-like). Median OS of 19 patients with metastases was 4.6 years (95% confidence interval (CI): 2.4-6.8), with 12 (63%) cases demonstrating aggressive behavior. <i>MUTYH</i> p.Gly396Asp and p.Tyr179Cys were the most frequent variants (mostly GPV). Of 13 tumors arising in patients with germline <i>MUTYH</i> mutations and tested for loss of heterozygosis of the wild allele, 6 (50%) exhibited a second hit event in <i>MUTYH</i>, with 4 demonstrating aggressive behavior. Tumor mutation burden (TMB) was low in the six treatment-naïve PanNET (TMB: 0-9) with this information, but three of seven tumors molecularly profiled after alkylating drugs and/or radioligand therapy had high TMB (TMB: 97, 65, and 728).</p><p><strong>Conclusion: </strong><i>MUTYH</i> mutation-associated PanNET (germline and/or somatic) is associated with aggressive and high-grade disease when metastatic.</p>","PeriodicalId":23053,"journal":{"name":"Therapeutic Advances in Medical Oncology","volume":"17 ","pages":"17588359251356335"},"PeriodicalIF":4.2,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12301599/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"First-line systemic therapy in patients with metastatic or locally advanced urothelial carcinoma: a systematic review and network meta-analysis of randomized controlled trials.","authors":"Yandong Xie, Haoyang Liu, Yanfeng Tang, Yaowen Zhang, Nanwei Xu, Fengnian Zhao, Jinge Zhao, Guangxi Sun, Zhenhua Liu, Pengfei Shen, Hao Zeng, Junru Chen","doi":"10.1177/17588359251357527","DOIUrl":"10.1177/17588359251357527","url":null,"abstract":"<p><strong>Background: </strong>The emergence of immune checkpoint inhibitors and antibody-drug conjugates has revolutionized the first-line treatment landscape for locally advanced or metastatic urothelial carcinoma (la/mUC). However, the optimal treatment strategy remains uncertain.</p><p><strong>Objectives: </strong>This network meta-analysis (NMA) aimed to evaluate the efficacy and safety of various first-line treatments for la/mUC.</p><p><strong>Design: </strong>Systematic literature review with a Bayesian NMA.</p><p><strong>Data sources and methods: </strong>Eligible studies were retrieved from PubMed, EMBASE, and Web of Science, with a search cutoff of July 2024. Randomized controlled trials (RCTs) evaluating first-line treatments for la/mUC were included. Pairwise comparisons and Bayesian NMA were conducted to compare overall survival (OS) and progression-free survival (PFS) using hazard ratios (HR) and 95% credible intervals (CrIs), and objective response rate (ORR) and treatment-related adverse events (TRAEs) using odds ratios and 95% CrIs.</p><p><strong>Results: </strong>In total, 17 articles involving 11 RCTs and 7586 patients were included. Enfortumab vedotin (EV) plus pembrolizumab demonstrated the most significant improvement in OS (HR 0.47, 95% CrI 0.38-0.58) compared to platinum-based chemotherapy in the overall populations, with consistent benefits across cisplatin-eligible, cisplatin-ineligible, and PD-L1-positive/negative subgroups. EV plus pembrolizumab also ranked highest for PFS (HR 0.45, 95% CrI 0.38-0.54) and had a favorable ORR compared to other regimens. In terms of safety, atezolizumab monotherapy exhibited the lowest incidence of high-grade TRAEs, EV plus pembrolizumab had higher overall TRAE rates but lower rates of grade 3 or higher TRAEs than platinum-based chemotherapy and nivolumab plus gemcitabine-cisplatin.</p><p><strong>Conclusion: </strong>This NMA provides the most comprehensive analysis of first-line treatments for la/mUC, integrating the latest clinical data. EV plus pembrolizumab demonstrated superior efficacy and acceptable safety profiles in overall and subgroup analyses, establishing it as a promising treatment option.</p><p><strong>Trial registration: </strong>The study was registered in PROSPERO (CRD42024502320).</p>","PeriodicalId":23053,"journal":{"name":"Therapeutic Advances in Medical Oncology","volume":"17 ","pages":"17588359251357527"},"PeriodicalIF":4.2,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12290386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extracellular vesicles-derived extracellular RNA in bladder cancer: current progress and future prospects.","authors":"Jinbang Chen, Xin Yang, Zihan Hao, Hongqian Guo, Ying Sun, Rong Yang","doi":"10.1177/17588359251349288","DOIUrl":"10.1177/17588359251349288","url":null,"abstract":"<p><p>Bladder cancer (BCa), ranked as the 10th most common malignancy worldwide, presents significant challenges due to its high recurrence rates and clinical heterogeneity. The current standard diagnostic methods, cystoscopy and urine cytology, demonstrate limited sensitivity, particularly for low-grade tumors, highlighting the urgent need for minimally invasive biomarkers. Extracellular vesicles (EVs), membrane-bound nanoparticles that carry extracellular RNA (exRNA), have emerged as critical players in BCa diagnostics and therapeutics. Recent advancements show that EVs-exRNA facilitates early detection, dynamic monitoring of disease progression, and prognosis prediction. EVs-exRNA, as promising biomarkers, have made substantial progress in BCa research. In this review, we examine the role of EVs-exRNA in BCa, investigate its diagnostic and prognostic value and discuss the challenges and future directions for its clinical application, aiming to provide new insights for future research in this field.</p>","PeriodicalId":23053,"journal":{"name":"Therapeutic Advances in Medical Oncology","volume":"17 ","pages":"17588359251349288"},"PeriodicalIF":4.2,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12301616/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144733361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of delayed addition of PD-1/PD-L1 inhibitors to chemotherapy on outcomes in patients with extensive-stage small cell lung cancer.","authors":"Shuangqing Lu, Chao Wang, Xiaoyang Zhai, Zhuoran Sun, Ke Zhao, Dawei Chen, Hui Zhu","doi":"10.1177/17588359251356919","DOIUrl":"10.1177/17588359251356919","url":null,"abstract":"<p><strong>Background: </strong>Immunotherapy combined with chemotherapy is the first-line treatment for extensive-stage small cell lung cancer (ES-SCLC). However, the effect of delayed initiation of immunotherapy on its efficacy remains unclear.</p><p><strong>Objectives: </strong>This study aimed to investigate the impact of the delayed addition of programmed death receptor 1/programmed death ligand 1 (PD-1/PD-L1) inhibitors on treatment outcomes in patients with ES-SCLC.</p><p><strong>Design: </strong>This retrospective cohort study used propensity score matching (PSM) to balance baseline characteristics.</p><p><strong>Methods: </strong>This study included 416 patients with ES-SCLC who received first-line immunotherapy between January 2020 and December 2022. Patients were categorized into two groups: delayed-immunotherapy (IO) (PD-1/PD-L1 inhibitors initiated during the 2nd or 3rd chemotherapy cycle) and early-IO (immunotherapy initiated during the first cycle). A 1:1 PSM was performed to balance baseline characteristics. The primary endpoints were overall survival (OS) and progression-free survival (PFS), which were analyzed using the Kaplan-Meier method and compared using log-rank tests.</p><p><strong>Results: </strong>Owing to the exclusion of PD-L1/PD-1 inhibitors from medical insurance, financial constraints, and poor physical condition of some patients, 72 patients were included in the delayed-IO group (second cycle: 41; third cycle: 31), while 344 were in the early-IO group. Before PSM, median OS and PFS in the delayed-IO group were 24.00 and 8.75 months, compared to 18.59 and 7.57 months in the early-IO group, with no significant differences (OS: HR 0.72, <i>p</i> = 0.054; PFS: HR 0.86, <i>p</i> = 0.281). After PSM (72 patients per group), the delayed-IO group showed significantly longer median OS (24.00 vs 18.79 months, HR 0.60, 95% CI 0.38-0.97, <i>p</i> = 0.037) and PFS (8.75 vs 6.49 months, HR 0.69, 95% CI 0.48-0.99, <i>p</i> = 0.044) compared to the early-IO group. These results suggest that, in specific patient populations, delayed immunotherapy may improve survival outcomes by optimizing patient condition or treatment response.</p><p><strong>Conclusion: </strong>In patients with ES-SCLC, delayed administration of PD-1/PD-L1 inhibitors during the second to fourth chemotherapy cycles improves survival outcomes compared to concurrent administration during the first cycle, with a similar safety profile. These results suggest that, in specific patient populations, delayed immunotherapy may improve survival outcomes by optimizing patient condition or treatment response.</p>","PeriodicalId":23053,"journal":{"name":"Therapeutic Advances in Medical Oncology","volume":"17 ","pages":"17588359251356919"},"PeriodicalIF":4.3,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12280550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691642","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immune checkpoint inhibitors improve the efficacy of neoadjuvant chemotherapy in advanced gastric cancer: a retrospective cohort study.","authors":"Yonghe Chen, Yi Lin, Yingying Xu, Jianwei Zhang, Shi Chen, Shuai Ye, Gang Liu, Lei Lian, Junsheng Peng","doi":"10.1177/17588359251346423","DOIUrl":"10.1177/17588359251346423","url":null,"abstract":"<p><strong>Background: </strong>Immune checkpoint inhibitors (ICIs) have demonstrated efficacy in metastatic gastric cancer. Their potential benefits in the neoadjuvant therapy for advanced gastric cancer (AGC) are promising but require real-world evidence.</p><p><strong>Objective: </strong>We aimed to assess the real-world impact of adding ICIs to neoadjuvant chemotherapy (NAC) in AGC patients.</p><p><strong>Design: </strong>This is a retrospective, propensity score-matched analysis of 580 AGC patients treated with NAC, with or without ICIs, followed by radical gastrectomy.</p><p><strong>Methods: </strong>Patients were matched using propensity score matching (PSM) to balance baseline characteristics. Pathological complete response (pCR) rates and toxicity were compared between the ICIs-Chemo and Chemo cohorts.</p><p><strong>Results: </strong>After PSM, 188 patients were included: 71 in the ICIs-Chemo cohort and 117 in the Chemo cohort. Chemotherapy regimens in both cohorts included SOX (49.5%, 93/188), FLOT (26.6%, 50/188), XELOX (12.8%, 24/188), and FOLFOX (11.2%, 21/188). The ICIs used were predominantly Sintilimab (67.6%, 48/71), followed by Tislelizumab (21.1%, 15/71), Nivolumab (7%, 5/71), and others (4.2%, 3/71). Adding ICIs to NAC significantly improved the pCR rate (ICIs-Chemo: 29.6% vs. Chemo: 13.7%, <i>p</i> = 0.014). The SOX regimen, with (37.1%, 13/35) or without ICIs (22.4%, 13/58), demonstrated the highest pCR rates. Subgroup analysis indicated that patients older than 60 years (OR = 3.86, <i>p</i> < 0.01) and those with moderately/well-differentiated tumors (OR = 4.27, <i>p</i> = 0.01) may derive greater benefit from adding ICIs. While overall toxicity and surgical complication rates were similar between cohorts, we observed two cases of suspected severe immune-related adverse events (irAEs).</p><p><strong>Conclusion: </strong>Adding ICIs to NAC regimens in AGC significantly improves pathological response. While overall toxicity is not increased, close monitoring for irAEs is necessary.</p>","PeriodicalId":23053,"journal":{"name":"Therapeutic Advances in Medical Oncology","volume":"17 ","pages":"17588359251346423"},"PeriodicalIF":4.3,"publicationDate":"2025-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12268129/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144660303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The IASLC uncertain resection, general overview, current evidence, and future prospects: a systematic review and meta-analysis.","authors":"Mingming Hu, Xiaomi Li, Maike Zheng, Jiaqi Yu, Baohua Lu, Ying Wang, Xiaoqing Cao, Chongyu Su, Yujie Dong, Xu Zhang, Tongmei Zhang","doi":"10.1177/17588359251344789","DOIUrl":"10.1177/17588359251344789","url":null,"abstract":"<p><strong>Background: </strong>Introduced by the International Association for the Study of Lung Cancer (IASLC) in 2005, uncertain resection (Run) categorizes a new subclass of residual tumor. Despite several studies, the prognostic significance of Run in operable non-small cell lung cancer (NSCLC) remains unclear.</p><p><strong>Objectives: </strong>This study aimed to investigate the prognostic influence of Run in operable NSCLC, focusing on the impact of the four elements that comprise R descriptors on patient survival.</p><p><strong>Design: </strong>A systematic review and meta-analysis were conducted to synthesize data from relevant clinical studies.</p><p><strong>Methods: </strong>We developed search strategies to identify relevant clinical studies across databases including PubMed, Embase, Cochrane Library, Web of Science, CNKI, and Wanfang up to June 2024. Quantitative analysis was performed with Stata 15 to investigate the prognostic influence of Run, the extent of mediastinal lymph node removal, and the highest mediastinal lymph node involvement (HMLI). We also summarized the main findings from studies on pleural lavage cytology (PLC) and carcinoma in situ in operable NSCLC.</p><p><strong>Results: </strong>Compared to complete resection, Run-associated patients exhibited inferior 5-year overall survival (OS) and disease-free survival (DFS; risk ratio (RR) = 1.31, 95% confidence interval (CI) 1.19-1.44; RR = 1.43, 95% CI 1.28-1.60). Limited lymphadenectomy (L-LA) in cI stage showed similar survival benefit (OS, RR = 0.97, 95% CI 0.90-1.06; DFS, RR = 1.06, 95% CI 0.97-1.15), in contrast with systematic lymph node dissection (SLND). For pN2-III patients, HMLI indicated poorer OS (hazard ratio (HR) = 1.22, 95% CI 1.14-1.31) and DFS (HR = 1.25, 95% CI 1.14-1.36).</p><p><strong>Conclusion: </strong>IASLC's residual tumor classification correlated with significant survival differences. Compared with R0, Run was associated with inferior 5-year OS and DFS. L-LA seemed to provide equivalent survival benefits, in contrast to SLND. For patients with low invasiveness in stage cI, L-LA could be considered as a preferred option. HMLI predicts poorer survival in pN2-III patients, and positive PLC significantly worsened long-term survival in operable NSCLC, particularly at early stage.</p>","PeriodicalId":23053,"journal":{"name":"Therapeutic Advances in Medical Oncology","volume":"17 ","pages":"17588359251344789"},"PeriodicalIF":4.3,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12264421/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144650585","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}