BMC Cancer最新文献

{"title":"Decoupling T cell cytotoxicity: a CCL21+ICAM1-based synthetic immune niche enhances tumor elimination by accelerating lytic hit delivery.","authors":"Manish Kumar Gupta, Rawan Zoabi, Sofi Yado, Jörn Starruß, Benjamin Geiger, Haralampos Hatzikirou","doi":"10.1186/s12885-026-16748-y","DOIUrl":"10.1186/s12885-026-16748-y","url":null,"abstract":"<p><p>Preserving T cell cytotoxic function during ex vivo expansion remains a major challenge for adoptive cancer immunotherapy. A synthetic immune niche (SIN) composed of immobilized CCL21 and ICAM1 was shown to improve T cell expansion while preserving cytotoxicity; however, it remains unclear which specific step of the T cell killing process is enhanced by the SIN stimulation. Here, we combined advanced imaging based on time-lapse microscopy with a mean-field model to analyze the distinct stages in killing of B16 melanoma cells by CD8[Formula: see text] T cells. This framework enabled us to resolve the tumor cell killing process into discrete steps throughout target cell engagement with SIN-treated T cells and lytic hit delivery. We found that tumor cell death is best explained by a multi-hit process, requiring approximately four discrete hits to trigger cell death. Model-based analysis identified a significant increase in the lytic hit-delivery rate, [Formula: see text], as the main kinetic change associated with the enhanced cytotoxicity of SIN-treated T cells. The target encounter rate, [Formula: see text], could not be reliably compared between conditions because it was practically non-identifiable in the untreated dataset. Global sensitivity analysis further showed that increasing lytic hit delivery has a stronger effect on tumour control than increasing target encounter rates. These findings fundamentally reorient our understanding of optimized T cell manufacturing, suggesting that the lytic execution step may be the primary rate-limiting bottleneck in this in-vitro system, and that engineering strategies targeting granule polarization or discharge warrant prioritization alongside affinity-enhancement approaches.</p>","PeriodicalId":9131,"journal":{"name":"BMC Cancer","volume":"26 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13670589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179403","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":"Late enhancement and washout maps for distinguishing tumor progression from radiation necrosis in malignant brain tumors: an exploratory study.","authors":"Eya Khadhraoui, Leon Schmidt, Stefan Klebingat, I Erol Sandalcioglu, Roland Schwab, Philipp Arndt, Daniel Behme, Klaus-Peter Stein, Sebastian Johannes Müller","doi":"10.1186/s12885-026-17170-0","DOIUrl":"10.1186/s12885-026-17170-0","url":null,"abstract":"<p><strong>Background: </strong>Distinguishing between tumor progression and radiation necrosis during brain tumor follow-up is challenging. Advanced MR imaging techniques, such as perfusion, diffusion-weighted imaging (DWI), and spectroscopy, can help differentiate between these conditions. In our clinic, we established a novel technique, the rapid washout and late-enhancement map. This study investigated the value of this map in distinguishing true progression from radiation necrosis.</p><p><strong>Methods: </strong>Patients with a histologically confirmed initial diagnosis of glioblastoma, high-grade astrocytoma, primary central nervous system lymphoma, or brain metastasis who were undergoing radiochemotherapy and participated in our MRI protocol, including MR perfusion and rapid washout imaging, between January 1, 2024, and December 31, 2025, were included in the study. We volumetrically measured late enhancement and washout in brain tumors at all follow-up examinations and analyzed the resulting volumes. Additionally, we evaluated diffusion-weighted imaging and MR perfusion images.</p><p><strong>Results: </strong>A total of 33 patients (25 with glioblastoma, two with astrocytoma grade 4, two with astrocytoma grade 3, one with CNS lymphoma, and three with brain metastasis) were included. Diagnostic confirmation was obtained by histopathological assessment in 20 patients, MRI follow-up in 13 patients, with additional fluorodeoxyglucose-positron emission tomography in two. Among these patients, 23 were diagnosed with tumor recurrence, four with mixed pathology comprising \"radiation necrosis with scattered active tumor cells\", and six with radiation necrosis. The mean washout ratio (± standard deviation) was 31 ± 18 % for progressive disease, 35 ± 20 % for mixed pathology, and 10 ± 7 % for radiation necrosis, respectively.</p><p><strong>Conclusions: </strong>The washout ratio can enhance the differentiation between recurrent tumor growth and radiation necrosis during post-treatment monitoring of malignant brain tumors. As MR perfusion can yield inconclusive results in this setting, the proposed method offers complementary information that supports initial diagnostic decision making. Diagnostic discrimination may be strengthened by combining the relative cerebral blood volume with washout ratio analysis, rather than relying on a single imaging marker.</p>","PeriodicalId":9131,"journal":{"name":"BMC Cancer","volume":"26 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13673850/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149191191","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":"Association of regulatory B, T cells and cytokine production with disease stage in non-small cell lung cancer patients: prospective case control study.","authors":"Helal F Hetta, Asmaa M Zahran, Emad Eldin Nabil, Azza A Elkady, Asmaa M Goda, Tamer M Soliman, Abeer Elkady, Hend M Esmaeel, Abdelazeem M Algammal, Nahed A Mohamed, Hala M ElBadre, Hani Alrefai, Ashraf Elyamany, Ola A Alkady","doi":"10.1186/s12885-026-16464-7","DOIUrl":"10.1186/s12885-026-16464-7","url":null,"abstract":"<p><strong>Background and aim: </strong>The role of regulatory B cells (Bregs) cells and regulatory T cells (Tregs) has been little investigated in non-small cell lung cancer (NSCLC). Therefore, we investigated the frequency of circulating Bregs, Tregs cells, and the serum cytokine profile in NSCLC and their association with disease progression.</p><p><strong>Materials and methods: </strong>In this prospective case-control study, peripheral blood from 40 patients with NSCLC and 40 healthy controls was examined, the frequency of various lymphocyte subsets including Bregs and Tregs was evaluated using flow cytometry. Serum cytokine profile including IL1β, IL6, IL-17, TNF-α, IL10, IL35 and TGF-β1 was measured using Luminex assay.</p><p><strong>Results: </strong>An increased proportion of Bregs, Tregs, CD8 + T cells, and decreased CD4+/CD8 + ratio was observed in NSCLC patients compared to healthy controls. NSCLC patients with metastasis had a higher frequency of Bregs and Tregs than patients without metastasis. The frequency of Bregs and Tregs was related to the stage and histopathological status. NSCLC patients had significantly higher levels of serum cytokine profile when compared to healthy controls along with a significant association with lymph node metastasis and different TNM stages.</p><p><strong>Conclusions: </strong>Peripheral Bregs, Tregs, and serum cytokine profiles, including proinflammatory and anti-inflammatory cytokines were increased among NSCLC patients and may be associated with disease progression and metastasis.</p>","PeriodicalId":9131,"journal":{"name":"BMC Cancer","volume":"26 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13670730/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179326","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":"Transcriptomic profiling reveals autophagy-associated programs and prognostic biomarkers in anoikis-resistant pancreatic cancer cells.","authors":"Lizhi Lin, Monika Bauden, Roland Andersson, Daniel Ansari","doi":"10.1186/s12885-026-17107-7","DOIUrl":"10.1186/s12885-026-17107-7","url":null,"abstract":"<p><p>Pancreatic ductal adenocarcinoma (PDAC) is characterized by aggressive metastatic progression and poor clinical outcomes. During metastatic dissemination, detached tumor cells must overcome anoikis, a form of apoptosis induced by loss of extracellular matrix attachment. Although anoikis resistance is considered a critical prerequisite for metastasis, the adaptive mechanisms supporting detached survival in pancreatic cancer remain incompletely understood. In this study, anoikis-resistant (AR) pancreatic cancer cell models were established through repeated long-term suspension culture using Capan-1 and PSN-1 cells. Transcriptomic profiling was performed to identify conserved molecular programs associated with anoikis resistance in PDAC. Gene set variation analysis (GSVA) demonstrated consistent transcriptomic enrichment of autophagy-associated and suppression of cell cycle-related pathways in both AR models. Differential expression and integrative pathway analyses further identified several core genes associated with autophagy regulation and cytokine signaling. Survival analysis revealed that elevated expression of UBC and ATG14 was associated with poor prognosis in pancreatic cancer patients. Our findings suggest that suspension-selected pancreatic cancer cells undergo coordinated stress-adaptive transcriptional remodeling characterized by enriched autophagy- and ubiquitin-associated transcriptional programs.</p>","PeriodicalId":9131,"journal":{"name":"BMC Cancer","volume":"26 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13675964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149206457","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":"FGFR pathway inhibition enhances PD-1 blockade and modulates antitumor immunity in colorectal cancer models.","authors":"Zhou Shang, Changqing Jing, Jiyuan Liu, Baolin Zhang, Marta Rúbies Bedós, Irineos Papakyriacou, Yumeng Mao, Yuezhi Chen","doi":"10.1186/s12885-026-17105-9","DOIUrl":"10.1186/s12885-026-17105-9","url":null,"abstract":"<p><p>Immune checkpoint blockade (ICB) has demonstrated limited efficacy in microsatellite stable (MSS) colorectal cancer (CRC). The fibroblast growth factor receptor (FGFR) signaling pathway contributes to tumor immune evasion, yet its role in CRC remains insufficiently understood. We investigated the immunomodulatory effects of FGFR inhibition in combination with PD-1 blockade in murine CRC models. In vitro co-culture systems were used to evaluate T cell activation upon FGFR3 blockade. RNA sequencing and bioinformatics analyses, including The Cancer Genome Atlas (TCGA) dataset evaluation, were conducted to elucidate molecular mechanisms and clinical relevance. Combined FGFR inhibition and PD-1 blockade significantly reduced T cell exhaustion and promoted macrophage repolarization toward an antitumor phenotype. Transcriptomic profiling revealed upregulation of immune-related pathways and activation of immune-stimulatory genes. In vitro, FGFR3-specific monoclonal antibody treatment enhanced IFNg release following PD-1 blockade. Moreover, analysis of TCGA data demonstrated that high FGFR3 expression correlates with worse prognosis in CRC patients. Our findings suggest that FGFR pathway inhibition may enhance the efficacy of immune checkpoint blockade and provide a rationale for further investigation of FGFR-targeted combination strategies in MSS CRC.</p>","PeriodicalId":9131,"journal":{"name":"BMC Cancer","volume":"26 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13670699/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179408","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 treatment outcomes in HER2-altered advanced NSCLC: a real-world multi-center study comparing trastuzumab deruxtecan with conventional therapies and analysis by HER2/EGFR co-alteration status.","authors":"Chang Liu, Tao Li, Bo-Yu Qin, Lu Yu, Chenchen Ji, Min Liu, An Wang, Yong-Long Wang, Zhe-Feng Liu, Tong Zhang, Yi Hu","doi":"10.1186/s12885-026-16688-7","DOIUrl":"10.1186/s12885-026-16688-7","url":null,"abstract":"<p><strong>Background: </strong>First-line treatment options for HER2-altered advanced non-small cell lung cancer (NSCLC) remain limited, especially in cases with HER2-EGFR co-alterations. While new agents like trastuzumab deruxtecan (T-DXd) have emerged, its real-world evidence in first line remains limited.</p><p><strong>Methods: </strong>This study included patients with advanced NSCLC who had HER2 mutations or amplification and received first-line systemic therapy at six medical centers. Outcomes were evaluated following chemotherapy-based combinations, pan-HER tyrosine kinase inhibitors (TKIs), and T-DXd. Endpoints included progression-free survival (PFS), objective response rate (ORR), disease control rate (DCR), one-year and two-year survival rates, and toxicity.</p><p><strong>Results: </strong>A total of 69 patients were enrolled, comprising 45 with only HER2 alterations and 24 with HER2-EGFR co-alterations. In patients with only HER2-altered NSCLC, those receiving first-line T-DXd had an mPFS of 15.7 months (95% CI, 12.5-18.9), an ORR of 85.7%, and a DCR of 100.0%. The mPFS for patients receiving chemotherapy-based regimens, pan-HER TKIs, and chemotherapy plus pan-HER TKIs were 7.6 (95% CI, 6.6-8.5) months, 4.4 (95% CI, 4.0-4.9) months, and 7.0 (95% CI, 6.1-9.1) months, respectively. The ORR for the three groups above was 33.3%, 0, and 0, respectively. In subgroup analysis, patients with only HER2 alterations who did not harbor TP53 mutations had a longer PFS than those with TP53 co-mutations (8.7 m vs. 7.2 m; HR: 0.35; 95% CI: 0.11-0.99; P = 0.048). In patients with EGFR-HER2 co-alterations, first-line EGFR-TKI monotherapy yielded an mPFS of 9.7 (95% CI, 8.6-10.8) months, an ORR of 40.0%, and a DCR of 93.3%. Regarding safety, we did not observe Grade ≥ 3 TRAEs in first-line T-DXd treatment.</p><p><strong>Conclusions: </strong>First-line T-DXd showed promising activity signals in only HER2-altered NSCLC. In EGFR-HER2 co-altered patients, the EGFR-TKI monotherapy showed limited efficacy. The findings underscored the urgent need for prospective randomised trials.</p>","PeriodicalId":9131,"journal":{"name":"BMC Cancer","volume":"26 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13660007/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149164034","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":"Diagnostic interpretation of CFH expression in pan-cancer analyses: the importance of factor H-like 1 isoform resolution.","authors":"Simon J Clark","doi":"10.1186/s12885-026-17134-4","DOIUrl":"10.1186/s12885-026-17134-4","url":null,"abstract":"<p><p>Recent pan-cancer analyses have identified Complement Factor H (CFH) expression as an immune-related and prognostic biomarker. However, interpretation of CFH transcriptional data requires consideration of isoform specificity. The CFH gene encodes both full-length factor H (FH) and the biologically active splice isoform factor H-like 1 (FHL-1), which differ in structure and tissue localization. Common transcriptional and knockdown approaches do not distinguish between these isoforms, potentially introducing biological heterogeneity into diagnostic and prognostic assessments. Isoform-resolved analyses may therefore enhance the specificity and clinical utility of CFH-based biomarkers in oncology.</p>","PeriodicalId":9131,"journal":{"name":"BMC Cancer","volume":"26 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13654215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149164393","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":"Study protocol: a phase II study of trifluridine/tipiracil plus liposomal irinotecan as second-line therapy in advanced biliary tract cancer (TRITICC 2).","authors":"Linde Kehmann, Thorsten Götze, Maria Gonzalez-Carmona, Friedrich Foerster, Marie Berres, Raphael Mohr, Alexander Koch, Samayita Das, Nadja Drusenheimer, Tewodros Kebede, Markus Joerdens, Tom Luedde, Christoph Roderburg","doi":"10.1186/s12885-026-17089-6","DOIUrl":"10.1186/s12885-026-17089-6","url":null,"abstract":"<p><strong>Background: </strong>The prognosis of patients with advanced biliary tract cancer progressing after gemcitabine-based first-line therapy remains poor. Effective second-line treatment options are limited, and outcomes with currently available regimens are modest. Trifluridine/tipiracil (FTD/TPI) and nanoliposomal irinotecan (nal-IRI) have demonstrated clinical activity in gastrointestinal malignancies and may provide synergistic antitumor effects.</p><p><strong>Methods: </strong>TRITICC-2 is an investigator-initiated, prospective, open-label, multicenter, single-arm phase II trial conducted at academic centers in Germany. The study evaluates the efficacy and safety of FTD/TPI in combination with nal-IRI in patients with histologically confirmed, unresectable or metastatic biliary tract cancer who have progressed on gemcitabine-based first-line therapy. A total of 38 patients are planned for enrollment. Treatment consists of oral FTD/TPI administered on days 1-5 combined with intravenous nal-IRI on day 1 of a 14-day cycle, continued until disease progression, unacceptable toxicity, or withdrawal of consent. The primary endpoint is progression-free survival (PFS). Secondary endpoints include overall survival (OS), objective response rate (ORR), safety, and health-related quality of life. An optional translational research program includes serial liquid biopsies and biomarker analyses. Enrollment is ongoing, with recruitment initiated in late 2025. Efficacy, safety, and translational analyses are pending.</p><p><strong>Conclusion: </strong>TRITICC-2 investigates a biologically rational combination of FTD/TPI and nal-IRI in a patient population with a high unmet medical need. The study is expected to provide prospective data on the clinical activity and safety of this regimen and may contribute to the identification of biomarkers associated with treatment response in advanced biliary tract cancer.</p><p><strong>Trial registration: </strong>EUCT 2024-517330-18-00.</p>","PeriodicalId":9131,"journal":{"name":"BMC Cancer","volume":"26 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13670747/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179391","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":"Machine learning model for the prediction of pathological complete response after neoadjuvant chemotherapy in breast cancer.","authors":"Eva Reisig, Lie Cai, Maria Müller, Benedikt Schäfgen, André Pfob","doi":"10.1186/s12885-026-17115-7","DOIUrl":"10.1186/s12885-026-17115-7","url":null,"abstract":"<p><strong>Background: </strong>Breast cancer patients receiving neoadjuvant treatment may benefit from a presurgical assessment of complete response to avoid unnecessary surgeries. We aimed to develop a machine learning model that predicts pathological complete response (pCR) based on results from different image modalities as well as tumor and patient characteristics.</p><p><strong>Methods: </strong>Clinical data from 388 cases of invasive breast cancer receiving neoadjuvant treatment were extracted in this retrospective, monocentric study. Findings from ultrasound, mammography and magnetic resonance imaging combined with patient and histopathological information were included. A Pearson Product-Moment correlation and a LASSO regularization were performed to preselect the most relevant features for the outcome. Based on the preselected variables, we developed and validated a machine learning algorithm (logistic regression with elastic net penalty (GLM)) to predict pCR. The model's performance was evaluated via area under the curve (AUROC), false positive rate (FPR) and positive predictive value (PPV).</p><p><strong>Results: </strong>In the total cohort, pCR was detected in 158 out of 388 cases, resulting in a pCR rate of 40.7%. From 111 collected variables, 8 variables were removed due to a high correlation with other features. After the LASSO regularization, 14 variables were included as predictors for the final model. In the validation set, the GLM achieved an AUROC of 0.76 with a FPR of 8.7% and a PPV of 75%.</p><p><strong>Conclusions: </strong>Through the combination of imaging and clinicopathological features, our machine learning model shows a promising approach to improve the prediction of pCR in breast cancer patients receiving neoadjuvant treatment. In combination with the LASSO regularization, it allows interesting insights into the predictive potential of different variables, which are available as part of standard clinical practice.</p><p><strong>Trial registration: </strong>Not applicable.</p>","PeriodicalId":9131,"journal":{"name":"BMC Cancer","volume":"26 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13670700/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179361","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 and recovery after Covid-19 on breast cancer diagnosis and care in Johannesburg, South Africa.","authors":"Rebaone Petlele, Raylton Prosper Chikwati, Olaide Olawumi Ojoniyi, Monica Ewomazino Akokuwebe, Wenlong Carl Chen, Nivashini Murugan, Phumudzo Ndwambi, Linda Kumirayi, Furhana Jassat, Sarah Nietz, Rofhiwa Margaret Mathiba, Karisma Singh, Phyllis Ohene-Agyei, Valerie McCormack, Shane Anthony Norris, Maureen Joffe","doi":"10.1186/s12885-026-17068-x","DOIUrl":"10.1186/s12885-026-17068-x","url":null,"abstract":"<p><strong>Background: </strong>COVID-19 negatively impacted cancer diagnostic and treatment services worldwide. These challenges were further compounded in low- and middle-income countries, where longstanding resource constraints limited the capacity to maintain standard treatment pathways. We aimed to assess the impact of COVID-19 on (i) stage at diagnosis and time intervals from symptom recognition to a pathological confirmed breast cancer (BC) diagnosis and (ii) treatment initiation at two academic hospitals in Johannesburg; Chris Hani Baragwaneth Academic Hospital (Site 1) and Charlotte Maxeke Johannesburg Academic Hospital (Site 2).</p><p><strong>Methods: </strong>We compared the proportion of BC cases diagnosed at a late stage (stage III/IV) and median time intervals of pre-contact (T₁), diagnostic (T₂) and treatment initiation following diagnosis (T₃) pre, during and post COVID-19 among 2522 women. Using cumulative Kaplan-Meier time-to-event analysis we assessed the proportions of women achieving internationally benchmarked intervals.</p><p><strong>Results: </strong>Late-stage BC diagnoses increased during COVID-19 but subsequently recovered, with pre-, during-; and post-COVID-19 percentages, respectively, of 50%, 60% and 53% at Site 1 and 63%, 69% and 55% at Site 2. Compared to pre-COVID-19, at Site 1 the T₁ interval increased during and post COVID-19 (from 0.8 (IQR: 0.3-4.0) months to 1.0 (IQR: 0.5-6.0) and 2.0 (IQR: 0.5-6.0) post COVID-19 (P < 0.001), respectively); there were no significant T₁ changes at Site 2. Delays more than 3 months were associated with late-stage diagnosis. T₂ intervals did not differ significantly across COVID-19 periods at both sites. The treatment interval (T₃) at Site 1increased from a pre-COVID-19 median of 1.6 (IQR: 1.0-2.6) to 2.0 (IQR: 1.2-4.3) during COVID-19 and remained at 2.0 (IQR: 1.1-4.0) post COVID-19 (P < 0.001); at Site 2 an increase also occurred during COVID-19 but was not significant. Internationally benchmarked staging and timeliness targets were never achieved.</p><p><strong>Conclusions: </strong>The already high prevalence of late-stage at diagnosis increased further during the COVID-19 pandemic with evidence of recovery at both sites in the post COVID-19 period. Treatment initiation delays increased and surgery volumes decreased during the pandemic and did not recover to pre-pandemic levels. Our study shows current cancer human and facility resources are insufficient to manage the steadily increasing BC burden in Johannesburg, South Africa.</p>","PeriodicalId":9131,"journal":{"name":"BMC Cancer","volume":"26 1","pages":""},"PeriodicalIF":4.1,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13634214/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104213","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}