Current Problems in Cancer最新文献

{"title":"Title Page","authors":"","doi":"10.1016/S0147-0272(24)00024-2","DOIUrl":"https://doi.org/10.1016/S0147-0272(24)00024-2","url":null,"abstract":"","PeriodicalId":55193,"journal":{"name":"Current Problems in Cancer","volume":"49 ","pages":"Article 101083"},"PeriodicalIF":2.6,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140645834","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":"Enhancing skin lesion classification with advanced deep learning ensemble models: a path towards accurate medical diagnostics","authors":"Kavitha Munuswamy Selvaraj ,&nbsp;Sumathy Gnanagurusubbiah ,&nbsp;Reena Roy Roby Roy ,&nbsp;Jasmine Hephzipah John peter ,&nbsp;Sarala Balu","doi":"10.1016/j.currproblcancer.2024.101077","DOIUrl":"10.1016/j.currproblcancer.2024.101077","url":null,"abstract":"<div><p>Skin cancer, including the highly lethal malignant melanoma, poses a significant global health challenge with a rising incidence rate. Early detection plays a pivotal role in improving survival rates. This study aims to develop an advanced deep learning-based approach for accurate skin lesion classification, addressing challenges such as limited data availability, class imbalance, and noise. Modern deep neural network designs, such as ResNeXt101, SeResNeXt101, ResNet152V2, DenseNet201, GoogLeNet, and Xception, which are used in the study and ze optimised using the SGD technique. The dataset comprises diverse skin lesion images from the HAM10000 and ISIC datasets. Noise and artifacts are tackled using image inpainting, and data augmentation techniques enhance training sample diversity. The ensemble technique is utilized, creating both average and weighted average ensemble models. Grid search optimizes model weight distribution. The individual models exhibit varying performance, with metrics including recall, precision, F1 score, and MCC. The \"Average ensemble model\" achieves harmonious balance, emphasizing precision, F1 score, and recall, yielding high performance. The \"Weighted ensemble model\" capitalizes on individual models' strengths, showcasing heightened precision and MCC, yielding outstanding performance. The ensemble models consistently outperform individual models, with the average ensemble model attaining a macro-average ROC-AUC score of 96 % and the weighted ensemble model achieving a macro-average ROC-AUC score of 97 %. This research demonstrates the efficacy of ensemble techniques in significantly improving skin lesion classification accuracy. By harnessing the strengths of individual models and addressing their limitations, the ensemble models exhibit robust and reliable performance across various metrics. The findings underscore the potential of ensemble techniques in enhancing medical diagnostics and contributing to improved patient outcomes in skin lesion diagnosis.</p></div>","PeriodicalId":55193,"journal":{"name":"Current Problems in Cancer","volume":"49 ","pages":"Article 101077"},"PeriodicalIF":2.6,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140121460","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":"MET alterations in advanced non-small cell lung cancer","authors":"Gabriel Cavalcante Lima Chagas ,&nbsp;Amanda Ribeiro Rangel ,&nbsp;Badi El Osta","doi":"10.1016/j.currproblcancer.2024.101075","DOIUrl":"10.1016/j.currproblcancer.2024.101075","url":null,"abstract":"<div><p>Precision medicine has helped identify several tumor molecular aberrations to be treated with targeted therapies. These therapies showed substantial improvement in efficacy without excessive toxicity in patients with specific oncogenic drivers with advanced cancers. In metastatic lung cancers, the implementation of broad platforms for molecular tumor sequencing has helped oncology providers identify oncogenic drivers linked with better outcomes when treated upfront with targeted therapies. Mesenchymal-epithelial transition factor (<em>MET</em>) alterations are present in up to 60% of non-small cell lung cancer and are associated with a poor prognosis. Capmatinib and tepotinib are currently the only two approved targeted therapies by the U.S. Food and Drug Administration (FDA) for patients with <em>MET exon 14 skipping</em> mutation. Several agents are being developed to tackle an unmet need in patients with <em>MET</em> alterations. Some of these agents are being used in combination with <em>EGFR</em> targeted therapy to mitigate resistance to <em>EGFR</em> inhibitor. These agents are poised to provide new hope for these patients.</p></div>","PeriodicalId":55193,"journal":{"name":"Current Problems in Cancer","volume":"49 ","pages":"Article 101075"},"PeriodicalIF":2.6,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140121461","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":"Familial and Social Implications of Breast and Gynaecological cancer in Kerala, India","authors":"Lorane Scaria ,&nbsp;Saju Madavanakadu Devassy ,&nbsp;Lynette Joubert","doi":"10.1016/j.currproblcancer.2024.101080","DOIUrl":"10.1016/j.currproblcancer.2024.101080","url":null,"abstract":"<div><h3>Background</h3><p>Due to the paucity of reliable data to determine the components of family-based comprehensive care for cancer in India, we explored the familial implications of gynaecological and breast cancer diagnosis and treatment through a mixed-method study.</p></div><div><h3>Methods</h3><p>The mixed method study included 130 women aged above 18 with a confirmed diagnosis of gynaecological or breast cancer recruited from three selected tertiary hospitals in Kerala, India. Information on quality of life (36-Item Short Form Survey (SF-36)), psychological distress (distress thermometer), and the familial, interpersonal, social, and community impacts of cancer (semi-structured interview guide) were elicited. Linear regression was used to identify the factors associated with distress and the factors were explored further using thematic analysis.</p></div><div><h3>Results</h3><p>Patients included in the study (n = 130; mean age 57.5 years) had moderate or mild (66.9%) to severe (25.4%) distress. Concerns about work (93%), difficulty in; home care and housing (82%), care for dependents (65%), unempathetic family (87.6%), isolation (70%), and body image (65%) were major reasons for their distress. Physiological, social, and family-related stressors among the respondents included challenges in physical functioning, intense physical symptoms like fatigue, loss of appetite and sleep, role restrictions, alterations in family responsibilities, functional dependency, inadequate family support, challenges in social and interpersonal interactions, and an unsupportive work environment.</p></div><div><h3>Conclusion</h3><p>Cancer is a health crisis that involves psychological, social, and economic distress, compelling professionals to design multifaceted individualized care packages rather than only concentrating on medical management to alleviate their distress.</p></div>","PeriodicalId":55193,"journal":{"name":"Current Problems in Cancer","volume":"49 ","pages":"Article 101080"},"PeriodicalIF":2.6,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140137439","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":"Information for Readers","authors":"","doi":"10.1016/S0147-0272(24)00025-4","DOIUrl":"https://doi.org/10.1016/S0147-0272(24)00025-4","url":null,"abstract":"","PeriodicalId":55193,"journal":{"name":"Current Problems in Cancer","volume":"49 ","pages":"Article 101084"},"PeriodicalIF":2.6,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140645835","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":"Current and emerging strategies for the management of advanced/metastatic lung neuroendocrine tumors","authors":"Megan Rutherford ,&nbsp;Margaret Wheless ,&nbsp;Katharine Thomas ,&nbsp;Robert A. Ramirez","doi":"10.1016/j.currproblcancer.2024.101061","DOIUrl":"10.1016/j.currproblcancer.2024.101061","url":null,"abstract":"<div><p><span><span><span>Pulmonary neuroendocrine tumors<span> represent a spectrum of disease ranging from typical carcinoid tumors to </span></span>small cell lung cancers<span><span>. The incidence of low-grade pulmonary NETs has been increasing, leading to improved awareness and the need for more treatment options for this rare cancer. </span>Somatostatin analogs continue to be the </span></span>backbone<span><span><span> of therapy and may be followed or accompanied by targeted therapy, chemotherapy, and </span>immune therapy. The recent addition of </span>peptide receptor<span> radionuclide therapy (PRRT) to the treatment armamentarium of NETs has led to the development of targeted alpha therapy to overcome PRRT resistance and minimize off-target adverse effects. Herein, we aim to highlight current treatment options for patients with advanced low grade pulmonary NETs along with emerging therapies, sequencing of therapies, upcoming </span></span></span>clinical trials, and the importance of a multidisciplinary team to improve patient outcomes.</p></div>","PeriodicalId":55193,"journal":{"name":"Current Problems in Cancer","volume":"49 ","pages":"Article 101061"},"PeriodicalIF":2.6,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139572217","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":"Targeting RET alterations in non-small cell lung cancer","authors":"Go Nishikawa ,&nbsp;Mark A. Klein","doi":"10.1016/j.currproblcancer.2024.101074","DOIUrl":"10.1016/j.currproblcancer.2024.101074","url":null,"abstract":"<div><p>Rearranged during transfection (RET) alterations, which lead to aberrant activation of the <em>RET</em> proto-oncogene, have been identified in various cancers. In non-small cell lung cancer (NSCLC), <em>RET</em> mutations often manifest as <em>RET</em> fusion genes and are observed in 1–2 % of patients with NSCLC. In recent years, selective RET inhibitors such as selpercatinib and pralsetinib, approved by the Food and Drug Administration (FDA) in 2020, have been part of the revolutionary changes in the treatment landscape for non-small cell lung cancer. While first-generation RET inhibitors have become part of the standard of care for <em>RET</em>-fusion positive NSCLC, a new challenge has emerged: acquired resistance to RET inhibitors. RET resistance is a complex phenomenon that can manifest as either on-target or off-target resistance. Numerous studies have been conducted to identify the mechanisms behind this resistance. This review provides an overview of the biology of <em>RET</em> in NSCLC, methods of <em>RET</em> testing, and a comprehensive analysis of the clinical outcomes associated with multikinase and selective RET inhibitors for NSCLC. Additionally, we will explore future perspectives for <em>RET</em> fusion-positive NSCLC, including ongoing trials and the challenges involved in overcoming resistance to RET inhibitors.</p></div>","PeriodicalId":55193,"journal":{"name":"Current Problems in Cancer","volume":"49 ","pages":"Article 101074"},"PeriodicalIF":2.6,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140144722","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":"Targeting MEK in non-small cell lung cancer","authors":"Matthew S. Lara ,&nbsp;Collin M. Blakely ,&nbsp;Jonathan W. Riess","doi":"10.1016/j.currproblcancer.2024.101065","DOIUrl":"10.1016/j.currproblcancer.2024.101065","url":null,"abstract":"<div><p>The mitogen-activated protein kinase (MAPK or MEK) pathway modulates tumor cell survival and proliferation in non-small cell lung cancer (NSCLC). Unlike RAS or EGFR, activating mutations in MEK are exceedingly rare in NSCLC. Instead, enhanced activation of the MEK pathway is often linked to increased signaling by upstream oncogenic driver mutations. Thus far, MEK inhibitor monotherapy has shown little promise. However, treatment strategies involving MEK inhibition in combination with other targeted therapies in other oncogene-driven NSCLC has proven to be encouraging. For example, MEK inhibition - when combined with BRAF inhibition, - has shown strong anti-tumor activity in BRAF V600 mutated NSCLC. In this review, recent data on MEK inhibitor strategies in NSCLC are summarized. Furthermore, ongoing early phase trials investigating MEK inhibitor combination therapy with immunotherapy, chemotherapy and other oncogene drivers are highlighted. These and other studies could help inform future rational combination strategies of MEK-ERK inhibition in oncogene-driven NSCLC.</p></div>","PeriodicalId":55193,"journal":{"name":"Current Problems in Cancer","volume":"49 ","pages":"Article 101065"},"PeriodicalIF":2.6,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0147027224000060/pdfft?md5=7053f13c97ee7fcc94fc61e82de9cba0&pid=1-s2.0-S0147027224000060-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139716585","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":"Comparative effectiveness of lenalidomide/dexamethasone-based triplet regimens for treatment of relapsed and/or refractory multiple myeloma in the United States: An analysis of real-world electronic health records data","authors":"Sikander Ailawadhi ,&nbsp;Mu Cheng ,&nbsp;Dasha Cherepanov ,&nbsp;Maral DerSarkissian ,&nbsp;Dawn Marie Stull ,&nbsp;Annalise Hilts ,&nbsp;Justin Chun ,&nbsp;Mei Sheng Duh ,&nbsp;Larysa Sanchez","doi":"10.1016/j.currproblcancer.2024.101078","DOIUrl":"https://doi.org/10.1016/j.currproblcancer.2024.101078","url":null,"abstract":"<div><h3>Background</h3><p>This retrospective longitudinal study compared the effectiveness of dexamethasone+lenalidomide (Rd)-based triplet regimens containing proteasome inhibitors (PIs) ixazomib (IRd), carfilzomib (KRd), and bortezomib (VRd) or monoclonal antibodies (MABs) elotuzumab (ERd) and daratumumab (DRd) in patients with relapsed/refractory multiple myeloma (RRMM)—including those with high cytogenetic risk—primarily treated at community oncology clinics in the United States.</p></div><div><h3>Methods</h3><p>Electronic health records of adult RRMM patients in a deidentified real-world database (01/01/2014–09/30/2020) who initiated IRd, KRd, VRd, ERd, or DRd in the second or later line of therapy (LOT) were analyzed. The index date was the date of initiation of each LOT and baseline was the 6-month pre-index period. Duration of therapy (DOT), time to next therapy (TTNT), progression-free survival (PFS), and overall survival (OS) were compared across regimens with multivariable Cox proportional hazards models.</p></div><div><h3>Results</h3><p>Of the 1,185 patients contributing 1,332 LOTs, 985 had standard cytogenetic risk (median age, 71 years) and 180 had high risk (median age, 69 years). Compared with other regimens, DRd was associated with longer DOT overall (adjusted hazard ratio [95 % confidence interval]: 1.84 [1.42, 2.38] vs. KRd, 1.65 [1.20, 2.28] vs. ERd, 1.58 [1.23, 2.04] vs. IRd, and 1.54 [1.18, 2.00] vs. VRd), and longer TTNT and PFS. KRd was associated with shorter OS compared with DRd (1.45 [1.01, 2.08]) and VRd (1.32 [1.01, 1.73]). High-risk patients had similar outcomes with all triplet regimens.</p></div><div><h3>Conclusion</h3><p>Although DRd improved clinical outcomes overall, Rd-based triplet regimens containing a PI or MAB are similarly effective in high-risk RRMM.</p></div>","PeriodicalId":55193,"journal":{"name":"Current Problems in Cancer","volume":"50 ","pages":"Article 101078"},"PeriodicalIF":2.6,"publicationDate":"2024-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140308720","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":"Efficacy and safety of selinexor for patients with relapsed and refractory multiple myeloma: A meta-analysis","authors":"Laila Shafei ,&nbsp;Shaima Bashir ,&nbsp;Esther W. Chan ,&nbsp;Dina Abushanab ,&nbsp;Anas Hamad ,&nbsp;Daoud Al-Badriyeh","doi":"10.1016/j.currproblcancer.2024.101076","DOIUrl":"https://doi.org/10.1016/j.currproblcancer.2024.101076","url":null,"abstract":"<div><h3>Purpose</h3><p>Selinexor is a first-in-class, oral selective-inhibitor-of-nuclear-export, granted accelerated approval by FDA (2019) for relapsed and refractory multiple myeloma (RRMM). We sought to quantitatively summarize the selinexor efficacy and safety in RRMM.</p></div><div><h3>Methods</h3><p>We searched PubMed, EMBASE, CENTRAL, clinicaltrial.gov, and google scholar, until May 2023, studies about selinexor use in RRMM. The outcome measures of interest were primarily efficacy outcomes, in addition to safety outcomes. Random-effect model analyses were performed, at statistical significance of P&lt;0.05, using the RevMan software.</p></div><div><h3>Results</h3><p>Meta-analyses of eleven included clinical trials yielded a significant 56.21% overall clinical benefit, 46.91% overall response, 4.89% complete response, 23.41% very good partial response, 24.68% partial response, and 28.06% stable disease rates with selinexor. Due to safety reasons, selinexor caused significant increase in discontinuation rate, 16.80%. Subgroup analyses demonstrated higher efficacy with selinexor plus dexamethasone and proteasome inhibitor combinations than with selinexor alone. The multiple myeloma type, high cytogenetic risk, refractory state, and advanced disease state did not affect performance. Risk of selection, performance, and detection biases were unclear in the included trials.</p></div><div><h3>Conclusion</h3><p>Selinexor led to significant positive responses with an acceptable safety profile in RRMM patients, despite higher rates of safety-related discontinuations. Selinexor-based combinations further enhanced response.</p></div>","PeriodicalId":55193,"journal":{"name":"Current Problems in Cancer","volume":"50 ","pages":"Article 101076"},"PeriodicalIF":2.6,"publicationDate":"2024-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140296641","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}