BMC Cancer最新文献

{"title":"Machine learning-based dynamic CEA trajectory and prognosis in gastric cancer.","authors":"Yonghe Chen, Dan Liu, Zhong Wang, Yi Lin, Xiaohan Jiang, Junjie Liu, Lei Lian","doi":"10.1186/s12885-025-14623-w","DOIUrl":"https://doi.org/10.1186/s12885-025-14623-w","url":null,"abstract":"<p><strong>Background: </strong>Static carcinoembryonic antigen (CEA) levels are well‑established prognostic markers in patients with gastric cancer, but the significance of their dynamic trajectories over time has rarely been reported.</p><p><strong>Methods: </strong>We analysed the perioperative CEA levels (presurgery, early postsurgery, and late postsurgery) of 578 gastric cancer patients who underwent curative resection, with a median follow-up of 29 months. We used the entire cohort for k-means clustering. Survival differences between clusters were assessed using Kaplan-Meier analysis and Cox regression.</p><p><strong>Results: </strong>Of the 578 patients, 15.57% exhibited elevated CEA levels before surgery (median 2.07 ng/mL), which then decreased to 3.29% (median 1.74 ng/mL) after surgery. However, after six months, a slight rebound was observed (18.51% elevated, median 2.98 ng/mL). K-means clustering identified three CEA trajectories: high, medium, and low (Calinski-Harabasz index: 358). Survival analysis demonstrated that higher CEA trajectories were associated with worse disease-free survival (DFS) and overall survival (OS). With the low cluster as a reference, multivariate Cox regression analysis revealed that a higher CEA trajectory was an independent prognostic factor, with an elevated risk in the high cluster (HR 2.64, 95% CI: 1.37-5.0), indicating that the high cluster had more than twice the mortality risk of the low cluster and that the medium cluster had a moderately increased mortality risk (HR 1.69, 95% CI: 1.0-2.85).</p><p><strong>Conclusion: </strong>Higher CEA trajectories are associated with a worse prognosis, highlighting the importance of enhanced monitoring for this group of patients.</p>","PeriodicalId":9131,"journal":{"name":"BMC Cancer","volume":"25 1","pages":"1221"},"PeriodicalIF":3.4,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144717463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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 analysis of lorlatinib for ALK-positive advanced NSCLC: a multicentre real-world study in China.","authors":"Zhujun Chen, Chunlan Tang, Xiangyu Ma, Panwen Tian, Liang Gong","doi":"10.1186/s12885-025-14631-w","DOIUrl":"https://doi.org/10.1186/s12885-025-14631-w","url":null,"abstract":"<p><strong>Background: </strong>Lorlatinib, a third-generation Anaplastic lymphoma kinase (ALK)-tyrosine kinase inhibitors (TKI), has demonstrated excellent curative effect in clinical studies to overcome mutations resistant to first- and second-generation ALK-TKIs. It also has improved blood-brain barrier crossing and reduced brain metastases.</p><p><strong>Methods: </strong>44 patients were selected who received Lorlatinib as initial treatment for first-diagnosis ALK-positive non-small-cell lung cancer (NSCLC) or who received Lorlatinib as a back-line treatment after developing resistance with first- and second-generation ALK-TKIs. The primary study endpoints are objective response rate (ORR) and disease control rate (DCR).</p><p><strong>Results: </strong>For the 44 patients, the overall ORR[95% confidence intervals (CI)]was 59% (95% CI: 51-69), the DCR was 93% (95% CI: 36-56). In the first-line treatment group(n = 15), lorlatinib showned an ORR 93% (95% CI: 52-81), and the DCR was 100% (95% CI: 47-78). Additionally, 29 patients who received sequential Lorlatinib after progression on at least one first- or second-generation ALK-TKI showned an ORR of 41% (95% CI: 41-63) and a DCR of 90% (95% CI: 20-40). Lorlatinib demonstrated strong intracranial efficacay, with an overall intracranial objective response rate (IC-ORR) of 74% (95% CI: 67-92) and an intracranial disease control rate (IC-DCR) of 96% (95% CI: 53-81) in 23 patients with brain metastase. Among them, the IC-ORR and IC-DCR of 7 patients who received Lorlatinib as first-line therapy were both 100% (95% CI: 89-103). For 16 patients who had received at least one ALK-TKI, the IC-ORR with Lorlatinib was 63% (95% CI: 51-90), and the IC-DCR was 94% (95% CI: 27-70). 44 patients treated with Lorlatinib, all at a starting dose of 100 mg/day, 77% experienced adverse events, with the most common associated adverse event being hyperlipidaemia, However the overall grading was mild to moderate, with only one case of a reduction in dosage to 75 mg.</p><p><strong>Conclusions: </strong>This real-world evidence demonstrates that Lorlatinib exhibits significant clinical efficacy and intracranial anti-tumor activity in the treatment of ALK + NSCLC patients, whether in first-line or post-first-line treatment, while being well tolerated.</p>","PeriodicalId":9131,"journal":{"name":"BMC Cancer","volume":"25 1","pages":"1216"},"PeriodicalIF":3.4,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144717459","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification of gastroenteropancreatic neuroendocrine tumor patients with high liver tumor burden based on clinicopathological features.","authors":"Nuerailaguli Jumai, Luohai Chen, Xiaoxuan Lin, Qiao He, Man Liu, Yuan Lin, Yanji Luo, Yu Wang, Min-Hu Chen, Xiangsong Zhang, Zhirong Zeng, Ning Zhang","doi":"10.1186/s12885-025-14535-9","DOIUrl":"https://doi.org/10.1186/s12885-025-14535-9","url":null,"abstract":"","PeriodicalId":9131,"journal":{"name":"BMC Cancer","volume":"25 1","pages":"1217"},"PeriodicalIF":3.4,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144717461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of first-line tyrosine kinase inhibitor selection on survival outcomes with second-line nivolumab in metastatic renal cell carcinoma.","authors":"Omer Faruk Kuzu, Hatice Bolek, Elif Sertesen Camoz, Hilal Karakas, Serhat Sekmek, Saadet Sim, Selver Isık, Murat Günaltılı, Aysun Fatma Akkus, Deniz Tural, Cagatay Arslan, Sema Sezin Goksu, Ozlem Nuray Sever, Cengiz Karacin, Mehmet Ali Nahit Sendur, Nuri Karadurmus, Emre Yekedüz, Yüksel Ürün","doi":"10.1186/s12885-025-14654-3","DOIUrl":"https://doi.org/10.1186/s12885-025-14654-3","url":null,"abstract":"<p><strong>Introduction: </strong>Access to first-line immune checkpoint inhibitor (ICI) combinations in metastatic renal cell carcinoma (mRCC) remains limited in many low- and middle-income countries. Consequently, tyrosine kinase inhibitors (TKIs) are still widely used. This study investigates the impact of first-line sunitinib versus pazopanib on survival outcomes with second-line nivolumab.</p><p><strong>Methods: </strong>We conducted a retrospective analysis of 245 patients with mRCC from the Turkish Oncology Group Kidney Cancer Consortium Database. Patients received first-line sunitinib or pazopanib, followed by second-line nivolumab. Primary endpoints were time to treatment failure (TTF) and overall survival (OS). Subgroup analyses were performed based on IMDC risk classification and presence of sarcomatoid features.</p><p><strong>Results: </strong>A total of 245 patients who were treated with sunitinib or pazopanib monotherapy as first-line treatment followed by nivolumab as second-line treatment were included in this study. Median TTF following nivolumab initiation was similar between prior sunitinib and pazopanib groups (7.79 vs 7.72 months; p = 0.892). Median OS-2 was 27.21 months with prior sunitinib and 18.92 months with prior pazopanib (p = 0.496). In patients with sarcomatoid features (n = 20), those pretreated with pazopanib demonstrated numerically longer OS-2 compared to sunitinib (p = 0.023), although the small sample size limits definitive conclusions.</p><p><strong>Conclusion: </strong>No significant differences in survival outcomes were observed between first-line sunitinib and pazopanib before nivolumab in mRCC. In the small subgroup with sarcomatoid features, pazopanib pre-treatment was associated with a numerically longer survival. These findings warrant cautious interpretation and further prospective validation, especially in resource-constrained settings.</p>","PeriodicalId":9131,"journal":{"name":"BMC Cancer","volume":"25 1","pages":"1220"},"PeriodicalIF":3.4,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144717462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of outcomes with elranatamab and real world treatments in the UK for triple class exposed relapsed and refractory multiple myeloma.","authors":"Carmen Tsang, Joseph E O'Reilly, Lewis Carpenter, Charles Duffield, Filipa Tunaru, Jamie Wallis, Alycia Perkins, Thomas Price, Sam Wood, Karthik Ramasamy","doi":"10.1186/s12885-025-14624-9","DOIUrl":"https://doi.org/10.1186/s12885-025-14624-9","url":null,"abstract":"<p><strong>Background: </strong>Patients with triple class exposed (TCE), relapsed and refractory (RR) multiple myeloma (MM) have limited treatment options and poor prognosis. Elranatamab, a bispecific BCMA-targeted antibody, is an investigational treatment for RRMM with demonstrated efficacy and safety in MagnetisMM-3, a single-arm, multi-centre, phase-2 study. This study aimed to characterise outcomes for real world TCE RRMM patients and to estimate the treatment effect of elranatamab compared to treatments available in routine clinical care for TCE RRMM in the NHS.</p><p><strong>Methods: </strong>A retrospective, observational, external control arm (ECA) study combining participants from a single arm, multi-centre phase 2 study, MagnetisMM-3, receiving elranatamab to compare patient characteristics and median survival using a comparator cohort of TCE RRMM patients treated with real world regimens in five UK centres between 2015 and 2023. Both naive and adjusted treatment effect estimates for progression free survival (PFS) and overall survival (OS) were obtained using inverse probability of treatment weighted (IPTW) Cox proportional hazards models and differences in restricted mean survival time (dRMST). Quantitative bias analysis was used to assess the robustness of effect estimates to unmeasured confounding.</p><p><strong>Results: </strong>From a total of 5,535 patients identified with a diagnosis of MM, 81 were identified as eligible for inclusion in the ECA. A total of 13 different regimens were recorded as being initiated from the real world RRMM at index date, the most common regimen was pomalidomide + dexamethasone (48.15%). Clinical outcomes in the ECA were poor (median PFS 3.71 months [95% confidence interval (CI) 2.73-4.73], median OS 11.00 months [8.02-18.10]). In unadjusted analyses the elranatamab cohort had significant improvements in PFS (dRMST 6.95 months [4.08-9.61]) and OS (Hazard Ratio (HR) 0.66 [0.45-0.96]). Adjusted analyses showed similar effects for PFS (dRMST 6.45 [3.05-9.45]) but were equivocal for OS (HR 0.75 [0.46-1.26]).</p><p><strong>Conclusion: </strong>This study provides recent real world evidence of poor outcomes in TCE RRMM in the UK. PFS was longer among patients who received elranatamab compared with treatments for TCE RRMM in routine UK clinical practice.</p>","PeriodicalId":9131,"journal":{"name":"BMC Cancer","volume":"25 1","pages":"1219"},"PeriodicalIF":3.4,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144717456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Rotterdam Oncology Documentation (RONCDOC) - a high-quality data warehouse and tissue collection for head and neck cancer.","authors":"Arta Hoesseini, Emilie A C Dronkers, Eveline Dieleman, Maria J De Herdt, Marjan H Wieringa, Marie-Louise F van Velthuysen, Marinella P J Oferman, Aniel Sewnaik, Dominiek Monserez, Stijn Keereweer, Jose A U Hardillo, Robert Jan Baatenburg de Jong","doi":"10.1186/s12885-025-14727-3","DOIUrl":"https://doi.org/10.1186/s12885-025-14727-3","url":null,"abstract":"","PeriodicalId":9131,"journal":{"name":"BMC Cancer","volume":"25 1","pages":"1213"},"PeriodicalIF":3.4,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144717457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dosimetric study of TrueBeam single-isocenter vs. Halcyon dual-isocenter VMAT radiotherapy plans for postoperative left-sided breast cancer.","authors":"Chaojun Chai, Kainan Shao, Guoping Shan, Pu Li, Fenglei Du, Yiwei Yang","doi":"10.1186/s12885-025-14574-2","DOIUrl":"https://doi.org/10.1186/s12885-025-14574-2","url":null,"abstract":"","PeriodicalId":9131,"journal":{"name":"BMC Cancer","volume":"25 1","pages":"1214"},"PeriodicalIF":3.4,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144717458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Expression and prognostic significance of MLH1 and GPRC5C in resectable hepatocellular carcinoma.","authors":"Jun Lu, Lei Li, Qing Chen, Bingqi Li, Siqian Ren, Meng Yuan, Meng Meng, Jian Lei, Yuntao Bing, Hangyan Wang, Zhaolai Ma, Dianrong Xiu, Chunhui Yuan","doi":"10.1186/s12885-025-14591-1","DOIUrl":"https://doi.org/10.1186/s12885-025-14591-1","url":null,"abstract":"<p><strong>Background: </strong>It has recently been shown that mut-L homolog 1 (MLH1), frequently lost in cancer initiation and progression, inhibited pancreatic cancer metastatic potential by downregulating G-protein coupled receptor C5C (GPRC5C). However, their expression and prognostic significance in hepatocellular carcinoma (HCC) has not been elucidated, especially for GPRC5C.</p><p><strong>Methods: </strong>We detected MLH1 and GPRC5C expression using the tissue microarray-based immunohistochemical staining in tumor and matched adjacent non-tumor liver (ANL) specimens from 230 patients who underwent radical resection for HCC. The correlations between staining H-scores and clinicopathologic parameters, overall and disease-free survival were then evaluated. Finally, the prognostic value of the genes was evaluated in the online publicly available Kaplan-Meier Plotter database.</p><p><strong>Results: </strong>Firstly, MLH1 expression was much lower in HCC than in ANL tissues, while GPRC5C had the opposite change. Spearman's correlation coefficient analysis showed that MLH1 and GPRC5C were of a strong negative correlation (P < 0.001). In addition, MLH1 was negatively related to AFP level, and GPRC5C was positively linked to tumor size and vascular invasion. Univariately, high MLH1 or GPRC5C expression was remarkably associated with better or poorer overall and disease-free survival, respectively. In multivariate analyses, GPRC5C remains to be a powerful determinant for both overall and disease-free survival, while MLH1 was significant only for overall survival. Lastly, MLH1 predicted recurrence-free and progression-free survival in the Kaplan-Meier Plotter, GPRC5C might have the adverse effect, although being not statistically significant.</p><p><strong>Conclusion: </strong>MLH1 and GPRC5C have divergent expressions with an inverse correlation and function as promising novel prognostic indicators in resectable HCC.</p>","PeriodicalId":9131,"journal":{"name":"BMC Cancer","volume":"25 1","pages":"1215"},"PeriodicalIF":3.4,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144717460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Racial and socioeconomic disparities in surgical management and outcomes in pancreatic adenocarcinoma: a single-center experience in the last 13 years.","authors":"Dauris Rosario Lora, Sarah Herrera Mercedes, Zoe Post, Wojciech Blogowski","doi":"10.1186/s12885-025-14588-w","DOIUrl":"https://doi.org/10.1186/s12885-025-14588-w","url":null,"abstract":"<p><strong>Background: </strong>Pancreatic adenocarcinoma (PaC) is an aggressive cancer with a poor prognosis. While disparities in surgical management and outcomes have been reported, most studies use outdated or population-level data, limiting their relevance in modern clinical settings. This study examined the impact of race and socioeconomic status on pancreatic resection rates and survival outcomes in PaC patients.</p><p><strong>Methods: </strong>A retrospective analysis of 525 patients diagnosed with PaC at a single institution (2010-2024) was conducted. Demographics, tumor characteristics, resection rates, and survival outcomes were assessed. Socioeconomic status was inferred from zip codes. Logistic regression and Cox proportional hazards models were used to evaluate treatment access and survival.</p><p><strong>Results: </strong>African American patients had lower resection rates than White patients (20.0% vs. 36.1%; p < 0.001), even after adjusting for resectable stages. Resection likelihood was reduced by being African American (OR 0.27; p < 0.001), older age (OR 0.97/year; p = 0.007), advanced stage (OR 0.09; p < 0.001), and lower education (OR 0.86; p = 0.003). Mean survival was shorter for African Americans than White patients (405.7 vs. 426.8 days; p < 0.001) but nonsignificant after adjustments (HR 1.19; p = 0.34).</p><p><strong>Conclusions: </strong>Racial and socioeconomic disparities persist in PaC surgical management, impacting outcomes. Addressing these inequities through improved access to care is essential for achieving more equitable treatment.</p>","PeriodicalId":9131,"journal":{"name":"BMC Cancer","volume":"25 1","pages":"1218"},"PeriodicalIF":3.4,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144717464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"LAMP3 signature affects cervical cancer progression through autophagy.","authors":"Haizhou Ji, Jianfeng Zheng, Li Liu, Qinying Liu, Xintong Cai, Liyan Ji, Yang Sun","doi":"10.1186/s12885-025-14596-w","DOIUrl":"https://doi.org/10.1186/s12885-025-14596-w","url":null,"abstract":"<p><strong>Background: </strong>Lysosomes are monolayer membrane-encapsulated organelles containing acid hydrolases, crucial for intracellular substance breakdown and cellular homeostasis. They are also involved in autophagy. Although autophagy is linked to cancer, the role of lysosome-related genes in cervical cancer prognosis remains unclear. This study aimed to develop a prognostic model for cervical cancer based on lysosome-related genes and explore its applications in the tumor microenvironment, radiotherapy prognosis, and clinical pharmacology.</p><p><strong>Methods: </strong>We identified differentially expressed lysosome-related genes in cervical cancer and normal tissues using the TCGA database. A prognostic model was constructed using LASSO-Cox regression, validated with ROC curves and PCA analysis, and further verified using the GEO dataset GSE63514. In vitro and in vivo experiments were conducted to explore key genes, and their biological significance and pharmacological potential were analyzed.</p><p><strong>Results: </strong>A five-gene (AP1B1, DNASE2, LAMP3, NPC1, and LAPTM4A) lysosome-associated prognostic model was developed. LAMP3 was identified as the most differentially expressed gene. Knockdown of LAMP3 significantly reduced cervical cancer cell migration and invasion through lysosomal and autophagic pathways. Daidzein was found to have high binding affinity for LAMP3, suggesting its therapeutic potential.</p><p><strong>Conclusion: </strong>Lysosome-related gene modeling has significant clinical value. LAMP3 knockdown inhibits cervical cancer progression by reducing autophagy and lysosomal function. Daidzein shows potential as a novel therapeutic agent. However, further validation in larger cohorts is needed due to the limited sample size in this study.</p>","PeriodicalId":9131,"journal":{"name":"BMC Cancer","volume":"25 1","pages":"1206"},"PeriodicalIF":3.4,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144706298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}